Key result
Left-sided cardiac catheterization induced transient complete heart block in the distal His-Purkinje system of a patient with right bundle branch and left anterior fascicular block.
Left-sided cardiac catheterization can induce transient complete heart block in patients with pre-existing right bundle branch block and left anterior fascicular block.
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May induce transient complete heart block during LV catheterization in bifascicular block; leaves open need for standby pacing.
A patient with right bundle branch block and left anterior fascicular block developed complete heart block during passage of a catheter into the left ventricle. Intracardiac electrograms showed the block to be in the distal His-Purkinje system. The block resolved without complications.
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Munsif et al. (1991) studied this question. Left-sided cardiac catheterization induced transient complete heart block in the distal His-Purkinje system of a patient with right bundle branch and left anterior fascicular block.
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