Complete heart block--an underappreciated serious complication of central venous catheter placement.
Central venous catheter (CVC) placement is a common bedside procedure that is frequently performed in critically ill patients. More than 5 million CVCs are inserted annually across the United States alone. Procedure-related complications may vary from minor bleeding to life-threatening complications such as arterial perforation and pneumothorax. Cardiac arrhythmias can often occur during the guidewire placement, and bundle-branch blocks have also been reported. We herewith report a case of complete heart block during CVC placement, which is a rare but serious complication of this procedure. Because the patient had a preexisting left bundle-branch block, complete heart block likely resulted from a probable trauma to the right bundle branch during the guidewire insertion.
Department of Internal Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USA. lovids@hotmail.com
Lovely
L
Chhabra
David H
DH
Spodick
D002037:Bundle-Branch Block / Q000150:complications* / Q000175:diagnosis*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006327:Heart Block / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged