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Complete heart block complicating retrograde left heart catheterization
A Feit1, R Kipperman, S Ursell
1Department of Internal Medicine, State University of New York Health Science Center, Brooklyn 11203-2098.
Insights
Complete heart block after cardiac catheterization poses a high risk of recurrence. Electrophysiologic study is essential for assessing and managing this serious complication in patients undergoing left heart catheterization.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Procedures
Background:
- Retrograde left heart catheterization is a common diagnostic procedure.
- Complete heart block is a rare but serious complication of cardiac catheterization.
Observation:
- Three cases of complete heart block following retrograde left heart catheterization are presented.
- In two cases, electrophysiologic study revealed block below the atrioventricular (AV) node.
- The third case experienced fatal recurrent complete heart block.
Findings:
- Complete heart block complicating retrograde left heart catheterization is not solely a procedural event.
- There is a significant risk of recurrent complete heart block after this procedure.
- Electrophysiologic study is crucial for risk stratification and management.
Implications:
- Patients experiencing heart block during catheterization require thorough electrophysiologic evaluation.
- This complication may necessitate long-term monitoring or intervention.
- Cardiologists should be aware of the potential for recurrent heart block and the importance of electrophysiologic assessment.
Abstract:
Three cases of complete heart block complicating retrograde left heart catheterization are presented. In two of the three cases, electrophysiologic study documented block below the AV (atrial ventricular) node. In the third recurrent complete heart block was fatal. It appears that complete heart block complicating retrograde left sided cardiac catheterization is not simply a pericatheterization event; rather, it appears that there is high risk of recurrent complete heart block and that electrophysiologic study is mandatory.