A Case of Third Degree Complete Atrio-Ventricular Block During Catheterization of an Internal Jugular Vein for Hemodialysis / 대한신장학회잡지

ABSTRACT

Cardiac arrhythmias are a potential complication in the placement of central venous catheter for hemodialysis. These arrhythmias are typically benign and can be resolved by withdrawing the offending guide-wire or repositioning the catheter tip. We report a case of unusual arrhythmia, a complete 3rd degree atrioventricular block (3rd AVB). A 47-year-old man was admitted with clinical findings suggestive of end stage renal disease. His electrocardiography revealed a complete left bundle branch block. During the placement of the wire for a hemodialysis catheter via the right internal jugular vein, he developed 3rd AVB and hypotension. Despite the withdrawal of the wire, the hemodynamic instability and 3rd AVB had been sustained, leading to the insertion of a temporary pac emaker. On the 7th day after the insertion of the temporary pacemaker, the 3rd AVB was spontaneously resolved. To the best of our knowledge, a 3rd AVB related to the insertion of a hemodialysis catheter has not been reported in Korea.