Ventricular arrhythmia onset during diagnostic coronary angiography with a 5F or 4F universal catheter

Of 18,365 patients who underwent coronary angiography with a 4F or 5F universal catheter between April 2004 and May 2007, 24 (0.131%) experienced sustained ventricular tachycardia or ventricular fibrillation during the procedure. There was no significant difference in any clinical or angiographic characteristic between patients who had a ventricular arrhythmia and those who did not. Of the 24 episodes of ventricular arrhythmia, 14 were related to catheter manipulation, 8 to ischemia, and 2 to the contrast medium, while the cause could not be clearly established in 4. The incidence of ventricular arrhythmia with a universal catheter was 0.131%, and with a preformed catheter, 0.054% (P=.72). The study shows that serious ventricular arrhythmia occurs only rarely as a complication when coronary angiography is carried out using modern techniques and that imperfect manipulation of the catheter explains most episodes.