SYNCHRONIZED DC SHOCK IN LONG STANDING PERSISTENT ATRIAL FIBRILLATION WITH BIFASCICULAR BLOCK ENDING IN CARDIAC ARREST: A CASE REPORT
DOI:
https://doi.org/10.17656/jsmc.10216Keywords:
DC-Cardioversion, Atrial fibrillation, Bifascicular blockAbstract
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.
References
Lown B, Perlroth MG, Kaidbey S, Abe T, Harken DE. “Cardioversion “ of atrial fibrillation . A report from the treatment of 65 episodes in 50 patients . N Eng J Med 1963;269:325-31. DOI: https://doi.org/10.1056/NEJM196308152690701
Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, et al. 2012 focused update of the ESC guidelines for the management of atrial fibrillation .Developed with the special contribution of the European Heart Rhythm Association. .Euro-pace 2012;14:1385-413
Botkin SB, Dhanekula LS, Olshansky B. Outpatient cardioversion of atrial fibrillation : efficacy, safety and costs. Am Heart J .2003; 145:233-238. DOI: https://doi.org/10.1067/mhj.2003.112
Gronberg T, Neotio I, Nikkinen M, et al . Arrhythmic complications after electrical cardioversion of acute atrial fibrillation: the FinCV study. Europace ,2013;15:1432-1435.53. DOI: https://doi.org/10.1093/europace/eut106
Kottkamp H. Fibrotic atrial cardiomyopathy : a specific disease /syndrome supplying substrates for atrial fibrillation , atrial tachycardia , sinus node disease ,AV node disease and thromboembolic complications. J Cardiovasc Electrophysiol 2012;23:797-799 DOI: https://doi.org/10.1111/j.1540-8167.2012.02341.x
Himansha M, Somashekhar G, Jayaprakash S, et al. Association of AF with significant interventricular conduction disease- A case report, Journal of Indian College of Cardiology JICC;5(2015) :157-159. DOI: https://doi.org/10.1016/j.jicc.2014.12.001
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