Ventricular Arrhythmias During Swan-Ganz Catheterization of the Critically III

Sprung, Charles L.; Jacobs, Lawrence J.; Caralis, Panagiota; Karpf, Michael

doi:10.1378/chest.79.4.413

Cited by 78 publications

(8 citation statements)

References 11 publications

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“…This study showed that ventricular arrhythmias (single and multiple) and multiple ventricular arrhythmias were observed in 85.6% and 44.8% of patients undergoing cardiovascular surgery, respectively. So far, several studies have reported incidence of arrhythmias during placement of the catheter[234578] and these results are summarized in Table 4. Interestingly, the results of these studies were various and our results were a little bit different from the previous data.…”

Section: Discussionmentioning

confidence: 99%

“…[2345] Predisposing factors, such as acidosis, hypoxia and electrolyte imbalance, and long placement time has been shown to increase incidence of the arrhythmias,[2] whereas another report did not show this correlation. [5] Keusch et al .…”

Section: Discussionmentioning

confidence: 99%

“…[1] So far, several previous clinical studies examined the incidence of ventricular arrhythmias during placement of PAC and several factors to facilitate ventricular arrhythmias. [2345] However, so far, there have been no studies to identify the risk factors to facilitate ventricular arrhythmias during placement of PAC by multivariable analysis. Thus, this study was performed to determine clinical factors which produce the ventricular arrhythmias in adult patients undergoing cardiac operations by multivariable analysis.…”

Section: Introductionmentioning

confidence: 99%

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An analysis of the factors producing multiple ventricular arrhythmias during pulmonary artery catheterization

et al. 2017

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Background:The development of arrhythmias during placement of a pulmonary artery catheter (PAC) is common.Aims:This study was designed to examine factors influencing development of ventricular arrhythmias in adult patients undergoing cardiovascular operations during the catheter placement.Settings and Designs:Prospective, observational, cohort study.Methods:We prospectively studied 174 patients undergoing cardiovascular operations. A PAC was inserted through the right internal jugular vein by staff anesthesiologists. Electrocardiography tracings were recorded as the catheter was advanced from the right atrium to the pulmonary artery. Arrhythmias were classified as absent, single, or multiple (two or more consecutive) ventricular arrhythmias. We examined risk factors to produce ventricular arrhythmias during the placement.Statistical Analysis:The data were analyzed using logistic regression analysis to assess factors for the occurrence of ventricular arrhythmias after univariate analyses.Results:Ventricular arrhythmias (single and multiple) occurred in 149 patients (85.6%) and multiple arrhythmias were observed in 78 patients (44.8%). There were no factors to facilitate the ventricular arrhythmias (single and multiple), whereas it showed that valvular diseases (P = 0.049) and the placement time (P < 0.001) are significant factors to produce multiple arrhythmias.Conclusion:Both valvular diseases and long placement time were significant risk factors to produce multiple ventricular arrhythmias during placement of a PAC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An analysis of the factors producing multiple ventricular arrhythmias during pulmonary artery catheterization

et al. 2017

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“…However, a significant number of patients who undergo pulmonary artery catheterization experience catheter-related complications such as cardiac arrhythmia, pulmonary infarction, catheter knotting, catheter entanglement with other endovascular structures, pulmonary artery rupture, thrombosis, and tricuspid valve rupture [3,4]. …”

Section: Discussionmentioning

confidence: 99%

“…These resolve either with the SG catheter advancement from the right ventricle into the pulmonary artery, or with the prompt SG catheter withdrawal into the right atrium or the superior vena cava. Fortunately, clinically significant VT or VF requiring treatment occurs in <1% of the patients, although fatal VT has been observed [4,5]. The risk factors for ventricular arrhythmia during the insertion of an SG catheter include prolonged catheterization time, a predisposition to PVC, liver transplantation, myocardial infarction or ischemia, shock, acidosis, sepsis, electrolyte disturbances, and increased sympathetic tone [3,4].…”

Section: Discussionmentioning

confidence: 99%

Postoperative Life-Threatening Recurrent Ventricular Arrhythmia Triggered by the Swan-Ganz Catheter in a Patient Undergoing Off-Pump Coronary Artery Bypass Surgery

Min

Choi

et al. 2014

Korean J Thorac Cardiovasc Surg

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Recurrent ventricular arrhythmia can be fatal and cause serious complications, particularly when it is caused immediately after an operation. Incorrect placement of a Swan-Ganz catheter can trigger life-threatening ventricular arrhythmia, but even intensive care specialists tend to miss this fact. Here, we report a case of recurrent ventricular arrhythmia causing a severe hemodynamic compromise; the arrhythmia was induced by a severely angulated Swan-Ganz catheter. The recurrent ventricular arrhythmia was not controlled by any measures including repositioning of the catheter, until the complete removal of the Swan-Ganz catheter. It is necessary to keep in mind that the position of the pulmonary artery catheter should be promptly checked if there is intractable recurrent ventricular arrhythmia.

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Incidence of severe ventricular arrhythmias during pulmonary artery catheterization in liver allograft recipients

Gwak

Kim

et al. 2007

Liver Transpl

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Liver allograft recipients may develop a hyperdynamic circulation and cardiac electrophysiologic abnormalities. The incidence of severe ventricular arrhythmias in liver allograft recipients during pulmonary artery (PA) catheterization was determined. One hundred five liver allograft recipients were studied prospectively; 5 of the patients with preexisting valvular heart disease, ischemic heart disease, or arrhythmias were excluded. Severe ventricular arrhythmia, defined as 3 or more consecutive ventricular premature beats occurring at a rate of Ͼ100 per minute, was observed in 37.0% of the patients during insertion of the catheter and in 25.0% of the patients during removal of the catheter. Two patients developed ventricular tachycardia, and 2 developed ventricular fibrillation; the arrhythmias in these 4 patients did not respond to appropriate pharmacological treatment but resolved promptly after removal of the PA catheter. The catheter transit time from the right ventricle to the pulmonary capillary wedge position was longer in patients with severe ventricular arrhythmia than in those without this arrhythmia (91.6 Ϯ 103. Liver transplantation is commonly associated with the administration of large volumes of fluid and massive hemorrhaging; predisposing factors include abnormalities of blood coagulation, the presence of numerous collateral vessels, and prolonged periods of surgery. Patients with end-stage chronic liver disease have a hyperdynamic circulation, features of which include increased cardiac output, tachycardia, and decreased systemic vascular resistance (SVR). These changes are associated with extensive arteriovenous communications and release of systemic vasodilators, such as glucagon, nitric oxide, ferritin, and vasoactive intestinal polypeptide. 1 Severe pulmonary hypertension or intrapulmonary arteriovenous shunts also occur in such patients. 2 Severe pulmonary hypertension is a contraindication to liver transplantation. Assessments of ventricular function are required throughout this procedure. Accordingly, in most centers, a pulmonary artery (PA) catheter is inserted routinely to evaluate cardiac function. The development of arrhythmias during the insertion of a PA catheter in patients undergoing cardiovascular surgery has been reported 3,4 (Fig. 1). However, the incidence of arrhythmias and hemodynamic changes in relation to the placement of a PA catheter in liver allograft recipients is unknown. Our experience with such patients suggests that the development of an arrhythmia commonly occurs during the insertion and removal of the catheter. The aim of this study was to examine prospectively arrhythmias and hemodynamic changes associated with PA catheterization in liver allograft recipients and to investigate possible factors responsible for these complications. PATIENTS AND METHODSThis study was approved by the local institutional review board on human studies; informed consent was

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Ventricular Arrhythmias During Swan-Ganz Catheterization of the Critically III

Cited by 78 publications

References 11 publications

An analysis of the factors producing multiple ventricular arrhythmias during pulmonary artery catheterization

An analysis of the factors producing multiple ventricular arrhythmias during pulmonary artery catheterization

Postoperative Life-Threatening Recurrent Ventricular Arrhythmia Triggered by the Swan-Ganz Catheter in a Patient Undergoing Off-Pump Coronary Artery Bypass Surgery

Incidence of severe ventricular arrhythmias during pulmonary artery catheterization in liver allograft recipients

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