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A Case of Transient Complete Heart Block During Left Heart Catheterization

Sushant Koirala1, Raed Qarajeh2, Fareed Collado2

  • 1Internal Medicine, Rush University Medical Center, Chicago, USA.

Cureus
|July 12, 2024
PubMed

Insights

Iatrogenic complete heart block is a rare complication of left heart catheterization in patients with right bundle branch block. Operators should anticipate and prepare for this risk during the procedure.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Left heart catheterization is a common diagnostic procedure.
  • Right bundle branch block (RBBB) is a pre-existing condition in some patients undergoing cardiac procedures.

Observation:

  • An 84-year-old male with RBBB developed bradycardia and hypotension during left heart catheterization.
  • The patient experienced a complete heart block when the catheter crossed the aortic valve.

Findings:

  • The iatrogenic complete heart block was likely caused by left bundle branch irritation from the catheter.
  • A temporary transvenous pacer was successfully inserted, allowing the procedure to be completed.

Implications:

  • Clinicians performing left heart catheterizations in RBBB patients must be vigilant for potential iatrogenic complete heart block.
  • Preparedness for managing this rare complication is crucial for patient safety.

Keywords:
aortic valve diseasecardiac electrophysiologyiatrogenic transient heart blockintraprocedure complicationleft heart catheterization

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