Asystole Following Left Ventricular Pacing

Lai, Rebecca W.; Volosin, Kent J.

doi:10.1111/j.1540-8159.2004.00535.x

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…8 There is also an isolated case report of asystole with left ventricular pacing during LV lead implantation. 9 In these reports, hypotension and bradycardia were attributed to Bezold-Jarisch reflex due to direct C fiber stimulation.…”

Section: Discussionmentioning

confidence: 97%

“…There have been some case reports describing hypotension and bradycardia with radiofrequency ablation of atrioventricular node, 5 left‐sided accessory pathways through the transaortic approach, 6 left posteroseptal accessory pathway ablation via the CS, 7 and pulmonary vein ablation 8 . There is also an isolated case report of asystole with left ventricular pacing during LV lead implantation 9 . In these reports, hypotension and bradycardia were attributed to Bezold‐Jarisch reflex due to direct C fiber stimulation.…”

Section: Discussionmentioning

confidence: 99%

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Hemodynamic Collapse During Left Ventricular Lead Implantation

Punnam

Holiday

Janes

et al. 2007

Pacing Clinical Electrophis

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Hypotension as a procedural complication during cardiac resynchronization therapy (CRT) implantation was reported in the initial randomized clinical trials. However, this phenomenon is not well characterized. We reviewed our CRT implantation experience to better understand this issue. There were 105 patients who underwent left ventricular lead implantation for CRT. Four patients had marked hypotension (systolic blood pressure < or = 50 mmHg) during the procedure. All had a history of hypertension and diabetes mellitus and were pacemaker dependent. Two had normal renal function, one had moderate renal insufficiency, and one was on dialysis. Three patients had ischemic cardiomyopathy. All had left ventricular ejection fraction < or =20% and were in New York Heart Association class III. Propofol and midazolam were used for sedation as standard protocol. Two patients had sudden hypotension when the coronary sinus was being cannulated, and two patients experienced sudden hypotension during left ventricular pacing. Cardiac tamponade as a possible cause was ruled out by echocardiography. We discuss possible mechanisms of sudden hemodynamic collapse during CRT implantation.

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Section: Discussionmentioning

confidence: 97%