Ventricular fibrillation during electrical cardioversion of pre-excited atrial fibrillation |
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Authors: | Adlam D Azeem T |
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Institution: | Department of Cardiology, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK. davidadlam@doctors.org.uk |
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Abstract: | 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. |
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