Background
Significant bradycardia followed by cardiac arrest related to single bolus administration of X-ray contrast medium into a
peripheral artery has not, to our knowledge, been described in the literature.
Methods and Results
While performing a percutaneous transluminal angioplasty of the left superficial femoral artery in a 68-year old patient with
a pre-existing atrioventricular (AV) block, Wenckebach type, he developed an AV block III after a single bolus injection of
intra-arterial X-ray contrast medium.
Conclusion
We believe that application of contrast medium causes a transitory ischemia in the obstructed vessel and therefore elevation
of endogenous adenosine. In the case of a previously damaged AV node this elevation of endogenous adenosine may be responsible
for the development of a short period of third-degree AV block.
Keywords Adenosine - Atrioventricular node - Contrast medium - Percutaneous transluminal angioplasty