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BRIEF REPORT
Year : 2014  |  Volume : 4  |  Issue : 4  |  Page : 105

Central line placement may terminate ventricular tachycardia!


1 Division of Cardiovascular Medicine, University of Michigan, Medical Center, Ann Arbor, Michigan, USA
2 University of Aleppo School of Medicine, Aleppo, Syrian Arab Republic, Michigan, USA
3 Department of Internal Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Michigan, USA

Date of Web Publication12-Sep-2014

Correspondence Address:
Moutaz El Kadri
Division of Cardiovascular Medicine, University of Michigan, Medical Center, Ann Arbor, Michigan
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2231-0770.140662

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How to cite this article:
El Kadri M, Dabbagh GS, Zaitoun A. Central line placement may terminate ventricular tachycardia!. Avicenna J Med 2014;4:105

How to cite this URL:
El Kadri M, Dabbagh GS, Zaitoun A. Central line placement may terminate ventricular tachycardia!. Avicenna J Med [serial online] 2014 [cited 2020 Feb 26];4:105. Available from: http://www.avicennajmed.com/text.asp?2014/4/4/105/140662

A 75-year old man developed ventricular tachycardia (VT) whilst in hospital awaiting coronary artery bypass grafting. He was hemodynamically stable, therefore intravenous Amiodarone was recommended. This electrocardiogram (ECG) trace was recorded during the insertion of an internal jugular central venous line using the Seldinger technique [Figure 1]. The ECG demonstrates VT originating from the left ventricle (RBBB morphology, negative in lead I). As the guide wire was being introduced, it was transiently advanced too far triggering a burst of premature ventricular beats (PVB) originating from the right ventricle (LBBB morphology, positive in lead I). These PVBs with short coupling interval terminated the tachycardia and restored sinus rhythm in manner effectively analogous to VT termination with anti-tachycardia pacing (ATP) algorithms employed in implantable cardioverter-defibrillators (ICD). In our case, central line catheter was placed to provide central venous access and it was not intended to terminate the ventricular tachycardia. Central line insertion should never be considered as an option for termination of arrhythmia as it may cause serious complications including: Pneumothorax, air embolism, central line associated blood stream infections (CLABSIs), thrombosis. Central line insertion is occasionally associated with induction of ventricular and supraventricular arrhythmias, however successful termination of sustained arrhythmia is unusual.
Figure 1: (ECG) trace was recorded during the insertion of an internal jugular central venous line using the Seldinger technique

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