RESUMO
Background: Catheter-induced ectopic ventricular beats are observed in some patients. It is frequently stated that intracardiac foreign bodies such as an electrode catheters, a central venous line, or pulmonary artery catheter that migrates to the ventricle may give genesis to arrhythmia
Case Report: We report of life threatening ventricular arrhythmia occurring during insertion of a guide wire through the right jugular vein. A 41-years old man scheduled for elective coronary artery bypass graft [CABG], was referred to operating room. After induction of anesthesia and during insertion of the central venous catheter from right jugular vein, guide wire insertion resulted in sustained coarse ventricular fibrillation. The guide wire was removed immediately and treatment started. Defibrillation with 200, 300, 360 J, and antiarrhythmic drug therapy didn't convert this Coarse VF to normal rhythm. During the cardiopulmonary resuscitation [CPR] and chest compression the femoral artery and vein canulas were inserted and cardiopulmonary bypass was started. The surgical procedure was uneventful and at the end of operation patient's vital signs were stable. The patient stayed four days in ICU and at the 8th day after operation discharged from hospital with good general condition
Conclusion: Mechanical irritation of the cardiac chamber that commonly induces ectopic activity has abolished by removal of the stimulus, but in this case unresponsive life-threatening ventricular fibrillation was occurred
RESUMO
Background: Catheter-induced ectopic ventricular beats are observed in some patients. It is frequently stated that intracardiac foreign bodies such as an electrode catheters, a central venous line, or pulmonary artery catheter that migrates to the ventricle may give genesis to arrhythmia
Case report: We report of life threatening ventricular arrhythmia occurring during insertion of a guide wire through the right jugular vein. A 41-years old man scheduled for elective coronary artery bypass graft [CABG], was referred to operating room. After induction of anesthesia and during insertion of the central venous catheter from right jugular vein, guide wire insertion resulted in sustained coarse ventricular fibrillation. The guide wire was removed immediately and treatment started. Defibrillation with 200, 300, 360 J, and antiarrhythmic drug therapy didn't convert this Coarse VF to normal rhythm. During the cardiopulmonary resuscitation [CPR] and chest compression the femoral artery and vein canulas were inserted and cardio-pulmonary bypass was started. The surgical procedure was uneventful and at the end of operation patient's vital signs were stable. The patient stayed four days in ICU and at the 8[th] day after operation discharged from hospital with good general condition
Conclusion: Mechanical irritation of the cardiac chamber that commonly induces ectopic activity has abolished by removal of the stimulus, but in this case unresponsive life-threatening ventricular fibrillation was occurred