Abstract
Introduction: Endobronchial valve (EBV) placement is one technique to attain bronchoscopic lung volume reduction (BLVR). This procedure has shown clinical benefits in terms of lung function, symptoms, and quality of life. A few complications have been reported including pneumothorax, dislocation or migration of the valve, hemoptysis, COPD exacerbation, and pneumonia. However, supraventricular tachycardia (SVT) was not seen as a potential complication within 45 days of the procedure. Hypothesis: SVT is a complication of EBV placement to attain BLVR. Methods: We conducted a retrospective chart review of consecutive patients who underwent EBV placement between January 2018 and December 2021. Patients who developed SVT were compared to patient who did not get SVT. Results: A total of 94 cases were identified. The incidence of SVT was 18 (19.15%) cases post EBV placement. The patients who developed SVT were older (median [IQR]: 74 [69-76], 72.2% males and all were whites (100%). The time to develop SVT ranged between 2.5 hours and 118 hours with median 40.5 hours. 13 (72.2%, P= 0.007) of patients who developed SVT had an electrolyte imbalance post EBV placement. Electrolyte imbalance was an independent factor for predicting SVT on multiple regression after controlling for age, BMI, gender, and location of valve placement (adjusted OR, [CI 95%] 4.64, [1.41 - 15.29], P = 0.012). Placement of EBV in the lingula and left upper lobe (LUL) have higher incidence of SVT (5 (27.8%, P = 0.049) and 12 (66.7%, P = 0.071), respectively). Table 1 and Table 2 further summarizes the result from the study. Conclusion: Given the results, SVT can be recognized as a potential complication of BLVR. Additional caution must be paid to patients who have EBV placed in the LUL and patients with electrolyte imbalance post procedure. Electrolyte imbalance post procedure was the only statistically significant independent predicting factor for SVT. A larger study is needed to determine the level of association.
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