Ventricular fibrillation during electrical cardioversion of pre-excited atrial fibrillation.
The Wolff-Parkinson-White syndrome can rarely present with pre-excited atrial fibrillation. In this condition the short refractory period of the accessory pathway can lead to rapid atrioventricular conduction. There is then a danger that at high heart rates the irregular broad complex tachycardia that results can deteriorate into ventricular fibrillation. The initial management of patients presenting in pre-excited atrial fibrillation requires cardioversion to sinus rhythm. This can be performed by DC cardioversion or pharmacological means. This paper describes the case of a patient presenting in pre-excited atrial fibrillation where electrical DC cardioversion lead to transient iatrogenic ventricular fibrillation.
Adlam
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Department of Cardiology, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK. davidadlam@doctors.org.uk
Azeem
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T
D000328:Adult; D001281:Atrial Fibrillation / Q000628:therapy*; D004554:Electric Countershock / Q000009:adverse effects*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D014693:Ventricular Fibrillation / Q000209:etiology*; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications*