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CASE REPORT
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| Complete atrioventricular block during central venous catheter placement with pre-existing left bundle branch block: Preparedness guidelines |
| Sachin Kumar Amruthlal Jain1, Gokulakkrishna Subhas1 Saba Darda1 Shukri David1 |
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1Section of Cardiology, Department of Internal Medicine, Providence Hospital and Medical Centers, Southfield, MI, USA
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doi:10.5348/ijcri-2011-04-29-CR-4
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Address correspondence to: Dr. Sachin Kumar Amruthlal Jain Department of Internal Medicine Providence Hospital and Medical Centers 16001 W. Nine Mile Road Southfield, MI. 48075 USA Phone: 2489611758 Fax: 2488493151 Email: doctorsachin@gmail.com |
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| How to cite this article: |
| Jain SKA, Subhas G, Darda S, David S. Complete atrioventricular block during central venous catheter placement with pre-existing left bundle branch block: Preparedness guidelines. International Journal of Case Reports and Images 2011;2(4):15-18. |
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Abstract
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Introduction:
Injury to the right bundle causing Right Bundle Branch Block (RBBB) is a known complication of central line placement. Complete heart block may result in patients with pre-existing Left Bundle Branch Block (LBBB). There are no organized guidelines for preparedness in such condition.
Case Report: Seventy-eight-year old woman presented with intraparenchymal hemorrhage. Venous access was obtained in the right subclavian vein and guide wire was passed. As the catheter was passed over the guidewire, the rhythm went in complete heart block. She was paced with an external pacemaker. Review of her EKG revealed pre-existing LBBB. Conclusion: Clinicians should check the EKG before attempting central line placement in an elective/semi-emergent situation. Familiarize with the catheter and guide wire lengths/markings of the available kit. | |
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Key Words:
Complete heart block, Pre-existing left bundle branch block, Upper central venous line placement
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Author Contributions:
Sachin Kumar Amruthlal Jain - Substantial contributions to conception and design, acquisition of data, drafting the article, revising it critically for important intellectual content and final approval of the version to be published Gokulakkrishna Subhas - Substantial contributions to conception and design, acquisition of data, drafting the article, revising it critically for important intellectual content and final approval of the version to be published Saba Darda - Substantial contributions to conception and design, acquisition of data, drafting the article, revising it critically for important intellectual content and final approval of the version to be published Shukri David - Substantial contributions to conception and design, acquisition of data, drafting the article, revising it critically for important intellectual content and final approval of the version to be published |
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Guarantor of submission:
The corresponding author is the guarantor of submission. |
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Source of support:
None |
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Conflict of interest:
Authors declare no conflict of interest. |
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Copyright:
© Sachin Kumar Amruthlal Jain et. al. 2011; This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see copyright policy for more information.) |
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