Atrial fibrillation with rapid ventricular response resulting from low-voltage electrical injury.
BACKGROUND
Cardiac dysrhythmias after electrical injury have been reported previously, however, atrial fibrillation after low-voltage electrical injury is extremely rare. We present a case of atrial fibrillation with rapid ventricular response resulting from a low-voltage electrical injury.


METHODS
A 24-year-old active duty Navy sailor presented to the emergency department after an electrical shock from a 440-V furnace. He experienced severe pain in both hands and a racing sensation in his chest. He denied other symptoms. An electrocardiogram was performed demonstrating atrial fibrillation with a rapid ventricular response (132 beats/min). After analgesia and sedation, synchronized cardioversion (100 J) was performed with complete resolution of cardiac symptoms and restoration of normal sinus rhythm (75 beats/min). Cutaneous wounds were bandaged and the patient was discharged with cardiology follow-up. At follow-up, the patient reported no symptoms and an echocardiogram revealed no structural abnormalities.


CONCLUSIONS
Atrial fibrillation in the setting of electrical injury is rarely reported in the published medical literature. In patients without history suggestive of cardiac structural abnormalities, synchronized cardioversion is a potential option for restoration of normal sinus rhythm and resolution of symptoms after electrical injury-induced atrial fibrillation with rapid ventricular response.
Department of Emergency Medicine, Navy Medical Center San Diego, San Diego, California.
Stephen
S
Zanoni
John A
JA
Siefert
Michael A
MA
Darracq
D001281:Atrial Fibrillation / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D004554:Electric Countershock; D004556:Electric Injuries / Q000150:complications*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008889:Military Personnel; D009326:Naval Medicine; D055815:Young Adult
atrial fibrillation; cardioversion; dysrhythmia; electrical injury; low-voltage injury; palpitations