Related Experiment Videos
Catheter-induced A-V nodal block occurring during electrophysiologic study
Insights
A rare case of catheter-induced atrioventricular (A-V) block occurred during an electrophysiology study. The heart block resolved spontaneously over 12 hours, highlighting a potential complication of cardiac catheterization.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Device Complications
Background:
- Electrophysiologic (EP) studies are crucial for diagnosing syncope.
- Atrioventricular (A-V) block can be a serious complication during cardiac procedures.
Observation:
- A patient undergoing an EP study for syncope developed sudden high-grade A-V block.
- The A-V block occurred as a coronary sinus electrode catheter was withdrawn.
Findings:
- The A-V block resolved over 12 hours, progressing through Type I second-degree and first-degree A-V block.
- This suggests transient A-V nodal or His bundle dysfunction induced by catheter contact.
Implications:
- This case highlights a rare but significant complication of cardiac catheterization.
- Understanding catheter-induced A-V block is important for procedural safety and patient outcomes.
Abstract:
We describe a patient who underwent electrophysiologic study for evaluation of recurrent syncope. No abnormalities were found but high-grade A-V block proximal to the His bundle depolarization developed abruptly as the coronary sinus electrode catheter was being withdrawn. The A-V block disappeared gradually over a 12-hour period, progressing to type I second-degree A-V block, and then to first-degree A-V block (due to prolonged A-V nodal conduction), prior to resuming normal conduction. We postulate that A-V block was induced by direct contact between the electrode catheter and the A-V node or very proximal His bundle. Catheter-induced A-V block at this site has been described only rarely, possibly because of the relatively protected location and the configuration of the A-V node.