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Complete heart block during cardiac catheterization in a normal individual
Insights
Cardiac catheterization can cause serious heart block complications. Continuous electrocardiographic monitoring is recommended to detect high-risk conduction disturbances during the procedure.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Cardiac catheterization is a common diagnostic procedure.
- Conduction disturbances can occur during cardiac catheterization.
Observation:
- A 44-year-old male developed third-degree heart block during cardiac catheterization.
- Right heart catheterization initially caused bifascicular block (right bundle branch block with left posterior hemiblock).
- Third-degree heart block occurred during the left heart catheterization procedure.
Findings:
- Bifascicular block and frontal plane axis shifts are high-risk patterns.
- These patterns can precede complete heart block.
Implications:
- Continuous electrocardiographic monitoring is crucial during cardiac catheterization.
- Early recognition of conduction disturbances can prevent severe outcomes.
- This case highlights the importance of vigilant monitoring in high-risk patients.
Abstract:
A 44-year-old white male who developed third-degree heart block during cardiac catheterization is presented. Right heart catheterization precipitated bifascicular block, right bundle branch block with left posterior hemiblock, and resulted in third-degree heart block during the left heart procedure. It is recommended that multiple electrocardiographic lead monitoring be considered during cardiac catheterization in order to recognize more easily high-risk conduction disturbances, ie a bifascicular block pattern with frontal plane axis shifts.