Published online Oct 26, 2021. doi: 10.12998/wjcc.v9.i30.9192
Peer-review started: April 19, 2021
First decision: July 15, 2021
Revised: July 15, 2021
Accepted: September 6, 2021
Article in press: September 6, 2021
Published online: October 26, 2021
Esophagogastric varices are a common complication of cirrhosis with portal hypertension and endoscopic treatment has been recognized as a primary preventive and therapeutic option for such patients; however, it should be noted that bradyarrhythmia is regarded as one of the contraindications to endoscopic examination. Meanwhile, acute variceal bleeding may result in a high mortality rate in cirrhotic patients with portal hypertension accompanied by bradyarrhythmia. At present, there is an absence of reports concerning the treatment of such group of patients who underwent transjugular intrahepatic portosystemic shunt (TIPS). The present report details the case of a cirrhotic patient with acute variceal bleeding accompanied by bradyarrhythmia who underwent TIPS under temporary pacemaker protection.
We report the case of a 64-year-old male patient who was confirmed with bradyarrhythmia by ambulatory electrocardiogram 24 h before the operation. The patient was successfully treated by TIPS under temporary pacemaker protection.
In terms of cirrhotic patients with abnormal cardiac electrophysiological conduction, TIPS may be effective in reducing the complications of portal hypertension following the exclusion of severe pulmonary hypertension and heart failure, showing moderate feasibility in clinical applications.
Core Tip: Transjugular intrahepatic portosystemic shunt (TIPS) has been applied extensively in the treatment of cirrhotic patients presenting with portal hypertension; however, treating cirrhotic patients with bradyarrhythmia presents a great challenge due to the possibility of serious cardiac complications. In our case report, a 64-year-old male patient who was confirmed with bradyarrhythmia by ambulatory electrocardiogram 24 h before the operation was successfully treated by TIPS under temporary pacemaker protection.