Abstract
Arrhythmias (AR's) occurring during cath have not been systematically studied. Accordingly we prospectively analyzed 131 caths (23% emergency) in infants and children aged 3 hrs-14 yrs, mean 3±.26 (SE) yrs. VSD (22%), coarctations (13%) and tetralogy (9%) were the most common lesions. Seventy patients (53%) had AR's (149 episodes) and 19% had > 3 AR's. Multiple PVC's (>4 consecutive) accounted for 48% of AR and were benign, occurring with catheters in the right ventricle (RV)(63%) or left ventricle (LV) (25%). PVC runs ceased spontaneously or upon moving the catheter (99%). Similarly brady-AR's (sinus bradycardia N=15, 2° AV block N=3, complete AV block N=5) occurred with catheters in RV (9), LV (5) or right atrium (RA) (4). All atrial tachy-AR's, SVT (9), flutter (4), fibrillation (1) occurred with catheters in the RV, and 10 episodes of nodal rhythm occurred with catheters in RV (5) or RA (5). Excluding PVC's, i.e. for 79 AR's, moving the catheter or observation alone terminated 70% whereas atropine was effective in 18% (sinus bradycardia (11), complete AV block (3)). Cardioversion was used for one angio related episode of ventricular fibrillation. AR, especially sinus bradycardia, occurred more frequently in patients on digoxin (chi square p<.05). Nodal rhythm was less frequent with thorazine premedication (p<.05) but was more frequent in patients with VSD (p<.05). As such, AR was most common with catheters in RV>LV>RA, and in patients receiving digoxin. AR's were benign and easily treated.
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Sahn, D., Allen, H. & Goldberg, S. A PROSPECTIVE ANALYSIS OF ARRHYTHMIAS DURING CARDIAC CATHETERIZATION (CATH). Pediatr Res 11, 399 (1977). https://doi.org/10.1203/00006450-197704000-00181
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DOI: https://doi.org/10.1203/00006450-197704000-00181