Direct contact between an electrode catheter and the A-V node or proximal His bundle during an electrophysiologic study can rarely induce transient high-grade A-V block.
Catheter contact with the AV node may cause transient high-grade AV block during EP study; this case report leaves open its true incidence and procedural implications.
We describe a patient who underwent electrophysiologic study for evaluation of recurrent syncope. No abnormalities were found but high-grade A-V block proximal to the His bundle depolarization developed abruptly as the coronary sinus electrode catheter was being withdrawn. The A-V block disappeared gradually over a 12-hour period, progressing to type I second-degree A-V block, and then to first-degree A-V block (due to prolonged A-V nodal conduction), prior to resuming normal conduction. We postulate that A-V block was induced by direct contact between the electrode catheter and the A-V node or very proximal His bundle. Catheter-induced A-V block at this site has been described only rarely, possibly because of the relatively protected location and the configuration of the A-V node.
No takes yet. Share an insight, caveat, or question.
Peters et al. (1984) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: