Insertion of a pulmonary artery catheter in a patient with complete left bundle branch block induced a prolonged complete atrioventricular block requiring temporary cardiac pacing.
Case Report (n=1)
No
Insertion of a pulmonary artery catheter in patients with complete left bundle branch block can induce life-threatening, prolonged complete atrioventricular block, highlighting the need for prophylactic transcutaneous pacing pads.
Prolonged complete atrioventricular (AV) block occurred during insertion of a pulmonary artery catheter (PAC) in a patient with complete left bundle branch block (CLBBB). As escape beats did not appear for more than 10 seconds, we administered 0.05 mg of adrenaline intravenously. QRS waves soon appeared, but complete AV block persisted. Temporary cardiac pacing was introduced and necessary even after cardiopulmonary bypass until sinus rhythm was restored. The risk of complete AV block in patients with CLBBB should be considered when a PAC is inserted because the right bundle branch is located on the surface of the right ventricle.
Kitaura et al. (Sat,) conducted a case report in Complete left bundle branch block (CLBBB) (n=1). Pulmonary artery catheter (PAC) insertion was evaluated. Insertion of a pulmonary artery catheter in a patient with complete left bundle branch block induced a prolonged complete atrioventricular block requiring temporary cardiac pacing.