Intra-procedural arrhythmia during cardiac catheterization: A systematic review of literature

Cardiac catheterization is routine, but a catheter inside the heart can perturb its rhythm. This systematic review catalogs how often, and how dangerously.

Synthesizing over a hundred studies, the authors map the arrhythmias by procedure: transient conduction blocks (right bundle branch block, complete heart block) during right heart catheterization, and ventricular arrhythmias — including fibrillation — during left heart procedures, a risk that has fallen over time but persists, notably with adjuncts like OCT imaging and FFR measurement.

The practical takeaway is vigilance: most of these arrhythmias are benign and transient, but the rare life-threatening ventricular ones demand continuous monitoring and readiness to intervene during catheterization. The status-quo angle is gentle — it argues against complacency about a “routine” procedure’s risks.

We rate the evidence moderate: a comprehensive systematic review of more than 100 studies, though heterogeneity prevented a meta-analysis and limits quantitative precision; no conflicts declared. Its clinical significance is moderate — important safety awareness for proceduralists, though it reinforces existing standard-of-care vigilance rather than changing practice.