Dexmedetomidine Sedation Leading to Refractory Cardiogenic Shock

In Brief Dexmedetomidine is frequently used for deep sedation during electrophysiology procedures. We report a case where, presumably, the use of dexmedetomidine resulted in a patient's death. The patient developed unexplained and refractory cardiogenic shock and could not be resuscitated. Autopsy failed to demonstrate any abnormality or cause of death. We postulate that, in certain susceptible individuals, dexmedetomidine may lead to terminal complications. We therefore urge caution about using dexmedetomidine in the electrophysiology laboratory. IMPLICATIONS: Dexmedetomidine is usually well tolerated, with easily reversible side effects. However, a small percentage of patients seem to develop severe and refractory cardiovascular complications. In an effort to alert other physicians to use caution when administering dexmedetomidine, we report the death of a patient during an electrophysiologic procedure.