Abstract
Left heart catheterization by the right posterior transthoracic approach of Björk precipitates arrhythmias less frequently than does right heart catheterization. In this series of 300 consecutive left heart catheterizations no cases of ventricular tachycardia, fibrillation, cardiac standstill, or persistent complete A-V block were observed. Atrial and ventricular ectopic beats occurred in 63.3 per cent of the cases, paroxysmal atrial tachycardia in 1.3 per cent, rapid ventricular rate in established atrial fibrillation in 9.3 per cent, bradycardia in 2.6 per cent, nodal or coronary sinus rhythm in 2 per cent, and transient complete A-V block in 0.3 per cent. There was only one case of transient right bundle branch block and no case of left bundle branch block. Pre-existing bundle branch block does not contra-indicate the procedure. Age of the patient, digitalization, presence of cardiac failure do not predispose to a higher incidence of arrhythmias during left heart catheterization.
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