scholarly journals Complete Heart Block in a Diabetic Patient with a Preexisting LBBB and Normal Coronaries, Paradoxically Responding to Atropine

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Nikolaos S. Ioakeimidis ◽  
Dimitrios Valasiadis ◽  
Lykourgos Nanis ◽  
Pantelis Kligkatsis ◽  
Stefanos Papastefanou
Keyword(s):  
Sinus Rhythm ◽  
Heart Block ◽  
Complete Heart Block ◽  
Heart Rhythm ◽  
Hemodynamic Instability ◽  
Sudden Onset ◽  
Bundle Branch Block ◽  
Escape Rhythm ◽  
Tertiary Center ◽  
Peripheral Pulse

We present a case of a complete atrioventricular block (AV block) with different aberrancy patterns during sinus rhythm and escape rhythm. A 66-year-old woman visited our emergency department complaining of sudden onset dizziness and fatigue over the past thirty minutes. Her medical history was remarkable for arterial hypertension, type 2 diabetes mellitus, and hypothyroidism. The patient had a known Left Bundle Branch Block (LBBB) on past ECGs. Upon palpation of peripheral pulse, a measurement of 32 beats per minute was obtained. No other sign of hemodynamic instability was present. A 12-Lead ECG revealed a complete heart block with sparse QRS complexes with a Right Bundle Branch Block (RBBB) morphology. Before the insertion of a temporary transvenous pacemaker, atropine was administered intravenously. Shortly after the administration, the patient’s heart rhythm was restored to sinus rhythm (SR) with LBBB. The patient remained hemodynamically stable and in sinus rhythm at the cardiac ICU and was scheduled for implantation of a permanent pacemaker at a specialized tertiary center. Before successful implantation, a coronary angiography revealed normal coronary anatomy with no atherosclerotic lesions.

CARDIAC COMPLICATIONS OF DIPHTHERIA

PEDIATRICS ◽  
1963 ◽  
Vol 32 (4) ◽  
pp. 549-557
Author(s):  
Beverly C. Morgan
Keyword(s):  
Heart Block ◽  
Clinical Evidence ◽  
Complete Heart Block ◽  
Cardiac Complications ◽  
Respiratory Complications ◽  
Bundle Branch Block ◽  
Electrocardiographic Abnormalities

Ninety-eight cases of diphtheria were observed in a 5½ year period, and the cardiac findings were evaluated. There were nine deaths. Three patients were dead on arrival See Image in the PDF File at the hospital (without postmortem evidence of myocarditis) while three died of diphtheritic myocarditis and three as a result of respiratory complications. No child who succumbed had been immunized against diphtheria. Four patients developed electrocardiographic and clinical evidence of myocarditis, and three died. In addition, 27 children showed minor electrocardiographic abnormalities of questionable significance. No patient had clinical or pathological evidence of myocarditis in the absence of electrocardiographic abnormalities. Although transient nonspecific electrocardiorgaphic abnormalities are frequent, their significance remains unclear. Marked electrocardiographic abnormalities such as bundle-branch block, A-V dissociation, and complete heart block are diagnostic of myocarditis in patients with diphtheria.

Complete Heart Block Occurring during Cardiac Catheterization in Patients with Preexisting Bundle Branch Block

CHEST Journal ◽  
1974 ◽  
Vol 65 (1) ◽  
pp. 95-97 ◽  
Author(s):  
Demetrios Kimbiris ◽  
Leonard S. Dreifus ◽  
Joseph W. Linhart
Keyword(s):  
Cardiac Catheterization ◽  
Heart Block ◽  
Complete Heart Block ◽  
Bundle Branch Block

scholarly journals Ablation of the atrioventricular junction

EP Europace ◽  
1999 ◽  
Vol 1 (1) ◽  
pp. 26-29 ◽  
Author(s):  
H. J. Marshall ◽  
M. J. Griffith
Keyword(s):  
Sudden Death ◽  
Atrioventricular Block ◽  
Heart Block ◽  
Complete Heart Block ◽  
Atrioventricular Node ◽  
Radiofrequency Energy ◽  
Atrioventricular Junction ◽  
Escape Rhythm ◽  
The Right

Abstract Atrioventricular junctional ablation is an attempt to interrupt conduction from the atrium to the ventricle using radiofrequency energy. The objective is to ablate the compact atrioventricular node as high as possible, leaving a stable ventricular escape rhythm. The compact node is identified in part by its relation to His recordings and partly through the known anatomy. In our series of 115 consecutive patients, atrioventricular block was achieved from the right side in 96% of patients and the remainder had the atrioventricular node ablated from the left side. Long-term success, i.e. complete heart block, was achieved in all patients. Complications in this and other series are rare, but there remains concern about sudden death in these patients.

scholarly journals Iatrogenic Transient Complete Heart Block in a Preexisting LBBB

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Adil S. Wani ◽  
Adebayo Fasanya ◽  
Prachi Kalamkar ◽  
Christopher A. Bonnet ◽  
Omer A. Bajwa
Keyword(s):  
Heart Block ◽  
Complete Heart Block ◽  
Guide Wire ◽  
Venous Cannulation ◽  
Central Venous Cannulation ◽  
Central Venous ◽  
Bundle Branch Block ◽  
Fatal Arrhythmia ◽  
The Right ◽  
Cardiac Conducting System

Catheter induced cardiac arrhythmia is a well-known complication encountered during pulmonary artery or cardiac catheterization. Injury to the cardiac conducting system often involves the right bundle branch which in a patient with preexisting left bundle branch block can lead to fatal arrhythmia including asystole. Such a complication during central venous cannulation is rare as it usually does not enter the heart. The guide wire or the cannula itself can cause such an injury during central venous cannulation. The length of the guide wire, its rigidity, and lack of set guidelines for its insertion make it theoretically more prone to cause such an injury. We report a case of LBBB that went into transient complete heart block following guide wire insertion during a central venous cannulation procedure.

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