Arrhythmia during pulmonary artery AngioJet rheolytic thrombectomy: a report of 5 cases and review of literatures

Objective To explore the etiology of arrhythmia during pulmonary artery AngioJet rheolytic thrombectomy (ART) and possible treatment strategies. Methods A retrospective analysis was performed on 5 patients who suffered from massive acute pulmonary embolism with arrhythmia undergoing ART from Oct. 2017 to Apr. 2018. Results Three patients presented sinus bradycardia in operation. One patient experienced a second-degree Mobitz type I atrioventricular block during ART, but the patient’s condition recovered to normal after ART. One patient had a cardiac arrest during ART, and the patient was immediately given external chest compression and vasoactive drugs, which stabilized the heart rate after about 30s. After procedure, the patients were discharged without any postoperative complications. Conclusions Arrhythmia is one of the main complications associated with ART. Several hypotheses may explain these effects, the most convincing hypothesis is effects of high pressure injection fluid stimulating the intramural baroreceptors of the pulmonary artery. Shortening the single suction time (<7 s) could decrease the occurrence of arrhythmia effectively, which improves the safety of the operation and patients’ outcomes. Key words: AngioJet; AngioJet rheolytic thrombectomy; Acute pulmonary embolism; Arrhythmia