Incidence of cardiac dysrhythmias in patients during pulmonary artery catheter removal after cardiac surgery.

OBJECTIVE: No published studies focus on determining the frequency of dysrhythmias during pulmonary artery catheter removal by use of a standard technique. The objective was to assess the incidence and hemodynamic effect of dysrhythmias in patients who had recently undergone cardiac surgery (within 24 hours of when dysrhythmia was noted).
METHODS: The study used an electrocardiogram recording by continuous rhythm strip during removal of the pulmonary artery catheter. Pulmonary artery catheters were removed by use of a standard procedure. Data were collected with respect to patients' serum potassium levels, acid-base status, and if they were receiving intravenous antiarrhythmic or inotropic drugs during the PAC removal procedure.
RESULTS: One hundred pulmonary artery catheters were removed, with the following types of dysrhythmia recorded: 2 patients had self-terminating ventricular tachycardia with transient hypotension; 1 patient had supraventricular tachycardia without hypotension; 13 patients had isolated ventricular ectopic dysrhythmia without hypotension; 2 patients had isolated atrial ectopic dysrhythmia without hypotension; and 1 patient had isolated atrial ectopic dysrhythmia and 3-beat supraventricular tachycardia without hypotension.
CONCLUSION: The use of a standard technique for pulmonary artery catheter removal demonstrated a 2% incidence of nonsustained ventricular tachycardia associated with transient hypotension. Fewer incidences of dysrhythmias were noted in the patients (4 of 29) who had abnormal serum potassium levels, abnormal pH, or pharmacologic association during catheter removal in comparison with those patients without this association (15 patients of 71). No statistically significant difference was noted in the incidence of dysrhythmia during pulmonary artery catheter removal between these 2 groups (chi(2) = 0.72, P =.39).