Risk Factors of Induced Cardiac Arrhythmia during the Central Venous Catheterization

ABSTRACT

PURPOSE: Central venous catheterization (CVC) is a common procedure in the emergency department (ED) and the intensive care unit (ICU) settings. There are some complications of this procedure, and one of those is a cardiac arrhythmia. But, it's risk factors have not been clearly defined compared with other complications of the procedure. Thus, we analyzed the frequency of arrhythmia occurrence and the factors that induced arrhythmia. METHODS: We performed a prospective study on all adult (>15 years old) patients who underwent a central venous catheterization using the right subclavian approach in the ED and the medial part ICU at Samsung Medical Center (SMC) during the period from May 1, 2004 to July 31, 2004. We excluded patients who experienced other complications of CVC (e.g, pneumothorax, hemothorax, etc.), or underwent a replacement of old catheter with new one, failed procedures also were excluded. Overall, 85 patients were included in study. We collected the data on patient's age, sex, body weight, height, use of catecholamines, place of the procedure, and length of guidewire insertion. The number of arrhythmia occurred was checked and later compared to the data collected previously. RESULTS: Among the 85 patients included in study, arrhythmia occurred in 31 patients. The length of guidewire insertion had statistical significance in induced arrhythmia during the procedures of CVC (p value=0.01). CONCLUSION: The length of guidewire insertion is a important risk factor of the arrhythmia occurrence during the procedure of central venous catheterization.