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Related Experiment Videos

Complete block below the His bundle induced by left-sided cardiac catheterization.

A N Munsif1, E Schechter

  • 1University of Oklahoma Health Sciences Center, Oklahoma City.

Catheterization and Cardiovascular Diagnosis
|November 1, 1991
PubMed
Summary

A patient experienced complete heart block during a cardiac catheterization procedure. This block, located in the distal His-Purkinje system, resolved spontaneously without complications.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Electrophysiology

Background:

  • Pre-existing conduction abnormalities, such as right bundle branch block and left anterior fascicular block, can predispose patients to further cardiac conduction disturbances.
  • Cardiac catheterization, while diagnostic and therapeutic, carries potential risks, including iatrogenic conduction abnormalities.

Observation:

  • A patient with documented right bundle branch block and left anterior fascicular block underwent left ventricular catheterization.
  • During the procedure, the patient acutely developed complete heart block.

Findings:

  • Intracardiac electrograms localized the site of the complete heart block to the distal His-Purkinje system.
  • The conduction block was transient and resolved spontaneously following the catheterization procedure.

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Implications:

  • This case highlights the vulnerability of the distal His-Purkinje system in patients with pre-existing conduction disease during invasive cardiac procedures.
  • Understanding the electrophysiological substrate is crucial for managing and preventing conduction abnormalities during catheterization.
  • Prompt recognition and monitoring can lead to favorable outcomes, even in cases of complete heart block.