{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T16:05:53Z","timestamp":1778774753144,"version":"3.51.4"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T00:00:00Z","timestamp":1651104000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T00:00:00Z","timestamp":1651104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>First-degree atrioventricular block (AVB) may lead to complete AVB. Herein, we present a case of a complete AVB under thoracic epidural catheter infusion of ropivacaine with fentanyl in a patient with first-degree AVB and myasthenia gravis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 74-year-old woman with first-degree AVB underwent thymectomy for myasthenia gravis. Continuous thoracic epidural catheter infusion of 0.2% ropivacaine with fentanyl was initiated at 15 min before the end of the surgery. At 9 h postoperatively, the electrocardiogram showed a 10-s-long pause due to complete AVB. Thus, a temporary pacemaker was implanted, and at 19 h postoperatively on postoperative day 1, cardiac pacing was initiated and lasted approximately 30 s. After catheter removal, she had no further episodes of complete AVB.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>First-degree AVB may lead to complete AVB under the influence of thoracic epidural infusion of ropivacaine in patients with myasthenia gravis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40981-022-00524-5","type":"journal-article","created":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T04:45:05Z","timestamp":1651121105000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Complete atrioventricular block under epidural ropivacaine infusion in a patient with first-degree atrioventricular block and myasthenia gravis: a case report"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9210-9713","authenticated-orcid":false,"given":"Takuma","family":"Hashimoto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinobu","family":"Kuratomi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hayashi","family":"Yoshimura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,4,28]]},"reference":[{"key":"524_CR1","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1097\/01819236-201341040-00012","volume":"41","author":"CEL Sabogal","year":"2013","unstructured":"Sabogal CEL, Vivas DB. 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Ann Noninvasive Electrocardiol. 2013;18:215\u201324.","journal-title":"Ann Noninvasive Electrocardiol."},{"key":"524_CR6","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.ijcme.2014.08.003","volume":"5","author":"P Shivamurthy","year":"2014","unstructured":"Shivamurthy P, Parker MW. Cardiac manifestations of myasthenia gravis: a systematic review. IJC Metab Endocr. 2014;5:3\u20136.","journal-title":"IJC Metab Endocr."},{"key":"524_CR7","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1111\/ene.12234","volume":"21","author":"S Suzuki","year":"2014","unstructured":"Suzuki S, Baba A, Kaida K, Utsugisawa K, Kita Y, Tsugawa J, et al. Cardiac involvements in myasthenia gravis associated with anti-Kv1.4 antibodies. Eur J Neurol. 2014;21:223\u201330.","journal-title":"Eur J Neurol"},{"key":"524_CR8","first-page":"148","volume":"4","author":"M Elsheshtawy","year":"2016","unstructured":"Elsheshtawy M, Virparia V, Patel F, Khanna A. 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