Atrial fibrillation induced by the right atrial injection of cold fluids during thermodilution cardiac output determination: A case report

The introduction of thermister-tipped, flow-directed pulmonary artery catheters has facilitated greatly the repetitive determination of cardiac output in clinical practice, and such measurements are considered to be extremely safe (although there are risks associated with catheter placement). In particular, the required right atrial injection of cold fluid is generally of little consequence. Recently, however, we cared for a patient in whom two attempts to measure output by a thermodilution method resulted in the sudden onset of persistent atrial fibrillation with resultant hemodynamic changes.