A Prolonged Ventricular Standstill Episode During a Total Hip Replacement—A Case Report

Background: Ventricular standstill, defined as the complete cessation of ventricular contraction, is a rare and sometimes fatal phenomenon. Few cases have noted patients to be hemodynamically stable and asymptomatic during the event, and no cases have identified ventricular standstill to occur during surgery. Case Summary: A 63-year-old male presented after an elective right total hip replacement, with telemetry revealing a 20-s absence of ventricular contractility during surgery. This is consistent with ventricular standstill. The patient was asymptomatic and hemodynamically stable before, during, and after the event. Conclusions: This case is rare due to the prolonged episode of ventricular standstill that occurred during surgery and the fact that the patient remained hemodynamically stable. Possible pathophysiological mechanisms of action of this phenomenon include both a vasovagal and inflammatory response, especially in a surgical setting with anesthesia.