Chhabra Lovely, Spodick David H
Department of Internal Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USA.
J Electrocardiol. 2012 Nov-Dec;45(6):790-2. doi: 10.1016/j.jelectrocard.2012.06.005. Epub 2012 Jul 17.
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.
中心静脉导管（CVC）置入是一项常见的床边操作，在重症患者中经常进行。仅在美国，每年就有超过500万根CVC被插入。与操作相关的并发症可能从轻微出血到危及生命的并发症，如动脉穿孔和气胸。在导丝置入过程中经常会发生心律失常，也有束支传导阻滞的报道。我们在此报告一例CVC置入过程中发生的完全性心脏传导阻滞，这是该操作罕见但严重的并发症。由于患者既往有左束支传导阻滞，完全性心脏传导阻滞可能是导丝插入过程中右束支受到可能的创伤所致。
