An unusual cause of atrial fibrillation: exposure to insecticides.
BACKGROUND
Although there are many well-known cardiac results of insecticide poisoning, atrial fibrillation (AF) has not been reported as the result of insecticide intoxication.


METHODS
Twenty-six-year-old male, complaining of nausea and vomiting, presented to the emergency department with a history of methomyl dust exposure. All physical examination findings were normal except irregular heart rate on cardiac auscultation. The electrocardiogram of the patient showed AF with normal ventricular response. Patient's acetylcholinesterase (ACE) level was 3,319 IU/L in presentation and pralidoxim use was seen unnecessary for the treatment. The patient's rhythm spontaneously returned to sinus rhythm 24 hr after the presentation and no cardiopulmonary pathology was found during the follow-up. The patient was discharged without symptoms.


CONCLUSIONS
AF is a rare complication of insecticide intoxication. In this case, treatment of symptoms was adequate until a normal sinus rhythm returned.
Topacoglu
Hakan
H
Department of Emergency Medicine, School of Medicine, Dokuz Eylul University, Inciralti, Izmir, Turkey. hakan.topacoglu@deu.edu.tr
Unverir
Pinar
P
Erbil
Bulent
B
Sarikaya
Sezgin
S
D000110:Acetylcholinesterase / Q000097:blood; D000328:Adult; D001281:Atrial Fibrillation / Q000139:chemically induced*; D004391:Dust; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D008297:Male; D008724:Methomyl / Q000506:poisoning*; D016273:Occupational Exposure / Q000009:adverse effects*
D004391:Dust; D007306:Insecticides; D008724:Methomyl; D000110:Acetylcholinesterase