SYNCHRONIZED DC SHOCK IN LONG STANDING PERSISTENT ATRIAL FIBRILLATION WITH BIFASCICULAR BLOCK ENDING IN CARDIAC ARREST: A CASE REPORT

Amar Alhamdi a, Azad Jalal Ali b, and Nidham Alhassania c



a Division of Cardiology, Alhassani Heart Day Clinic, Sulaimani, Kurdistan Region, Iraq
b Department of Anesthesia, Shar Teaching Hospital, Sulaimani, Kurdistan Region, Iraq
c Divisions of Cardiology, Alhassani Heart Day Clinic, Sulaimani, Kurdistan Region, Iraq 

 
Submitted: 15/5/2019; Accepted: 27/6/2019; Published: 21/9/2019

ABSTRACT


We report a case of long-standing persistent atrial fibrillation and bifascular block exposed to synchronized DC- cardioversion which resulted in cardiac arrest, the patient resuscitated including temporary and then permanent pacemaker implantation. The patient recovered fully and stayed in sinus rhythm. Patients with atrial fibrillation and symptomatic bifascular block, exposed to synchronized DC shock to revert into sinus rhythm, should receive either temporary pacing cover for the electrical cardioversion procedure, or should have at least a single ventricular permanent pacemaker prior to cardioverting them into sinus rhythm by applying synchronized DC – shock, as the likelihood of developing sinus arrest and escape rhythm failure is significantly high.




KEYWORDS

DC-Cardioversion, Atrial fibrillation, Bifascicular block.