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Increased risk of ventricular fibrillation associated with temporary pacemaker use during coronary arteriography

M H Lehmann, A Cameron, H G Kemp

    Pacing and Clinical Electrophysiology : PACE
    |September 1, 1983
    PubMed

    Insights

    Temporary pacemakers during coronary arteriography significantly increase the risk of ventricular fibrillation, especially when combined with contrast dye injections. This finding highlights a critical safety consideration for patients undergoing cardiac procedures.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Medical Imaging

    Background:

    • Coronary arteriography involves contrast dye injections that can transiently lower the ventricular fibrillation threshold.
    • Factors promoting ventricular fibrillation during this procedure are not well-established.

    Purpose of the Study:

    • To investigate factors associated with dye-induced ventricular fibrillation during coronary arteriography.

    Main Methods:

    • Analysis of 3906 consecutive patients undergoing selective coronary arteriography with sodium meglumine diatrizoate.
    • Comparison of ventricular fibrillation incidence between patients with and without temporary right ventricular pacemakers.

    Main Results:

    • Dye-induced ventricular fibrillation occurred in 1.7% of patients (66/3906).
    • Patients with temporary right ventricular pacemakers had a nearly six-fold higher incidence of ventricular fibrillation (10% vs. 1.7%, P < .001).
    • Patients receiving pacemakers had a higher prevalence of conduction abnormalities.

    Conclusions:

    • The use of temporary right ventricular pacemakers is a significant risk factor for ventricular fibrillation during coronary arteriography.
    • Mechanical stimulation from pacing catheters may induce fibrillation more readily in contrast dye-sensitized ventricles.

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