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Complete atrioventricular block induced during left heart catheterization
Insights
Complete atrioventricular block (CAVB) is a rare cardiac catheterization complication. This case highlights CAVB development in a patient with pre-existing right bundle branch block due to mechanical His bundle injury during catheter passage.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Complications
Background:
- Complete atrioventricular block (CAVB) is an infrequent complication during cardiac catheterization procedures.
- Patients with pre-existing conduction abnormalities, such as right bundle branch block, may be at increased risk.
Observation:
- A patient with pre-existing complete right bundle branch block developed CAVB during a left-sided cardiac catheterization.
- The CAVB was triggered by the passage of a left-sided catheter through the aortic valve.
Findings:
- Mechanical compression of the His bundle by the cardiac catheter is the suspected cause of CAVB.
- This case underscores a specific mechanism for iatrogenic heart block during invasive cardiac procedures.
Implications:
- Physicians must remain vigilant for potential CAVB development during cardiac catheterization, especially in high-risk patients.
- Awareness of this complication can guide preventative strategies and prompt management during catheter-based interventions.
Abstract:
Complete atrioventricular block (CAVB) during cardiac catheterization is a rare complication. We describe a patient with preexisting complete right bundle branch block who developed CAVB during left-sided cardiac catheterization. CAVB was induced when a left-sided catheter was passed through the aortic valve. We speculate that the patient's His bundle was injured by mechanical compression. Physicians should always pay attention to the possibility of the development of CAVB during cardiac catheterization, particularly in patients with preexisting heart block.