Document Detail

Complete heart block during central venous catheter placement in a patient with pre-existing left bundle branch block.
MedLine Citation:
PMID:  14570803     Owner:  NLM     Status:  MEDLINE    
Heart block and arrhythmia are complications of pulmonary artery and cardiac catheterization. Injury to the conducting system of the heart often involves the right bundle causing right bundle branch block (RBBB). If patients already have left bundle branch block (LBBB), complete heart block (CHB) may result. After trauma, impairment of the right bundle is usually transient with recovery in hours, but complete heart block can lead to symptoms requiring invasive treatment. Similar complications are rare with insertion of central venous catheters, as they should not enter the heart. Injury to the right bundle during central venous catheter insertion can be by trauma from the guide wire or from the catheter itself. The function of the AV node and bundle of His in these patients has not been studied before. We report a patient with LBBB who developed CHB during insertion of a central venous cannula. Conduction through the AV node and His-Purkinje system was intact, showing that the transient RBBB was caused by traumatic injury rather than by other disease of the conduction system.
D Unnikrishnan; N Idris; N Varshneya
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  91     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-10-22     Completed Date:  2003-11-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  747-9     Citation Subset:  IM    
Department of Internal Medicine, Division of Cardiology, Our Lady of Mercy Medical Center, 600 East 233rd Street, Bronx, NY 10466, USA.
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MeSH Terms
Bundle-Branch Block / complications
Catheterization, Central Venous / adverse effects*
Heart Block / etiology*
Heart Conduction System / injuries
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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