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Related Experiment Videos

Complete atrioventricular block during left heart catheterization

Y Murasato1, K Ninomiya, M Imai

  • 1Department of Internal Medicine, Moji Rousai Hospital, University of Occupational and Environmental Health, Japan.

Japanese Circulation Journal
|August 1, 1994
PubMed
Summary
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Complete atrioventricular block (CAVB) is a rare complication during cardiac catheterization. Patients with pre-existing right bundle branch block and reduced left ventricular function are at higher risk.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Cardiac catheterization is a common diagnostic procedure.
  • Patients with pre-existing conduction abnormalities and reduced left ventricular function may be at increased risk for complications.

Observation:

  • A 75-year-old male with frequent ventricular premature contractions and reduced left ventricular function presented for cardiac catheterization.
  • ECG revealed complete right bundle branch block (RBBB) and left anterior hemiblock.
  • Complete atrioventricular block (CAVB) suddenly occurred during left ventricular catheter insertion.

Findings:

  • Electrophysiological study confirmed CAVB as HV block with HV prolongation in sinus rhythm.
  • Coronary angiography showed no obstructive lesions or spasm.
  • The CAVB was reproducible and persisted, necessitating a permanent pacemaker (DDD).

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Implications:

  • This case highlights the rare occurrence of induced CAVB during left heart catheterization.
  • Pre-existing RBBB, hemiblock, and reduced left ventricular function are potential risk factors.
  • Emergency pacing preparedness is crucial for high-risk patients undergoing cardiac catheterization.