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Yeungnam Univ J Med > Volume 32(2); 2015 > Article
Yeungnam University Journal of Medicine 2015;32(2):152-154.
DOI:    Published online December 31, 2015.
Complete atrioventricular block during tunneled cuffed hemodialysis catheter insertion in a patient with pre-existing left bundle branch block.
Eun Woo Choi, Ji Yoon Jung, Jun Huck Su, Sae Huyn Park, Kyu Hyang Cho, Kyung Woo Yoon, Jong Won Park, Jun Young Do, Seok Hui Kang
Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea.
Arrhythmias are complications of tunneled cuffed hemodialysis catheter insertion. Most complications associated with arrhythmias occur during guide-wire access, where the guide wire can cause traumatic damage to the conduction system of the heart. Conducting system injury in tunneled cuffed hemodialysis catheter insertion often involves the right bundle, causing right bundle branch block (RBBB). Transient RBBB with sinus rhythm is not usually accompanied by abnormal vital signs. However if patients already have left bundle branch block (LBBB), new onset RBBB can cause complete atrioventricular block (AVB), which can lead to fatal complications requiring invasive treatment. We report on a patient with LBBB who developed complete AVB during hemodialysis catheter insertion.
Key Words: Hemodialysis, Atrioventricular block, Left bundle branch block


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