Incidence of severe ventricular arrhythmias during pulmonary artery catheterization in liver allograft recipients.
Liver allograft recipients may develop a hyperdynamic circulation and cardiac electrophysiologic abnormalities. The incidence of severe ventricular arrhythmias in liver allograft recipients during pulmonary artery (PA) catheterization was determined. One hundred five liver allograft recipients were studied prospectively; 5 of the patients with preexisting valvular heart disease, ischemic heart disease, or arrhythmias were excluded. Severe ventricular arrhythmia, defined as 3 or more consecutive ventricular premature beats occurring at a rate of >100 per minute, was observed in 37.0% of the patients during insertion of the catheter and in 25.0% of the patients during removal of the catheter. Two patients developed ventricular tachycardia, and 2 developed ventricular fibrillation; the arrhythmias in these 4 patients did not respond to appropriate pharmacological treatment but resolved promptly after removal of the PA catheter. The catheter transit time from the right ventricle to the pulmonary capillary wedge position was longer in patients with severe ventricular arrhythmia than in those without this arrhythmia (91.6+/-103.6 s versus 53.3+/-18.4 s, P<0.05). In conclusion, patients undergoing liver transplantation have a high risk of developing a ventricular arrhythmia during PA catheterization.
Gwak
Mi Sook
MS
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kim
Jie Ae
JA
Kim
Gaab Soo
GS
Choi
Soo Joo
SJ
Ahn
Hyun
H
Lee
Jeong Jin
JJ
Lee
Sang
S
Kim
Myung
M
D002407:Catheterization, Swan-Ganz / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D014184:Transplantation, Homologous