Electrocardiographic changes during intrauterine contraceptive device insertion

Abstract

Because of the problem of the occurrence of bradycardia, syncope, and seizures with intrauterine contraceptive device (IUD) insertion, a study was performed during which 25 patients underwent electrocardiographic monitoring during intrauterine device insertion. Fourteen patients (56 per cent) showed significant heart rate slowing, of which 8 developed sinus bradycardia. One of these developed sinus arrest. Another patient had electrocardiographic findings of a variable A-V block and a nodal A-V junctional rhythm. The procedure of sounding the cervix and uterus in preparation for IUD insertion was as productive of electrocardiogram (ECG) changes as the subsequent IUD insertion. The electrocardiographic changes were consistent with increased vagal tone, although conclusive evidence is lacking regarding the etiology of the ECG changes.