Key result
RCA cannulation can induce transient complete heart block via left bundle impingement in pre-existing RBBB.
Why the study?
Complete heart block can occur during right coronary artery cannulation in patients with pre-existing uncomplicated right bundle branch block, but such complications are unusual and not well documented.
Case Report (n=1)
Highlights the rare risk of complete heart block during right coronary artery cannulation in patients with pre-existing right bundle branch block due to catheter impingement on the left bundle.
Risk of transient AV block warrants caution in RBBB patients undergoing RCA cannulation; leaves open whether pre-procedural pacing is indicated.
We report the unusual occurrence of complete heart block during attempted right coronary artery cannulation in a patient with pre-existing uncomplicated right bundle branch block (RBBB). This complication occurred due to accidental impingement of the Judkin's right coronary catheter on the left bundle when it transiently slipped across the aortic valve. The block resolved without any complication.
No takes yet. Share an insight, caveat, or question.
Gaglani et al. (1992) conducted a case report in Pre-existing uncomplicated right bundle branch block (RBBB) (n=1). Right coronary artery cannulation was evaluated on Complete heart block. Attempted right coronary artery cannulation in a patient with pre-existing right bundle branch block resulted in transient complete heart block due to accidental impingement on the left bundle.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: