Atrial Fibrillation Following Electrical Injury.

Wander, Gurpreet Singh; Bansal, Rajinder K.; Anand, Inder; Arora, Saurabh; Khurana, S; Chawla, L. S.

doi:10.1536/ihj.33.131

Cited by 9 publications

(7 citation statements)

References 4 publications

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“…Multiple management strategies have been used with varying degrees of success. DC cardioversion has been undertaken successfully on at least one patient,9 but has also been observed to fail 10. Oral quinidine has been seen to be successfull,11 as has intravenous digoxin 9 12.…”

Section: Discussionmentioning

confidence: 99%

“…DC cardioversion has been undertaken successfully on at least one patient,9 but has also been observed to fail 10. Oral quinidine has been seen to be successfull,11 as has intravenous digoxin 9 12. Amiodarone has been previously seen to restore sinus rhythm on a reliable basis,8 10 and is suggested by both National Institute for Health and Clinical Excellence13 and the American College of Chest Physicians14 as the secondary choice (after β blockade) for the chemical cardioversion of atrial fibrillation of acute onset in a haemodynamically stable patient.…”

Section: Discussionmentioning

confidence: 99%

“…Timely self-reversion to sinus rhythm has also been documented,6 9 15 but conversely in two cases the arrhythmia proved refractory to all forms of cardioversion for decades 16 17…”

Section: Discussionmentioning

confidence: 99%

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Electrocution-induced atrial fibrillation: a novel cause of a familiar arrhythmia

Langford

Dayer²

2012

Case Reports

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BACKGROUNDThis case presents a novel aetiology of a common arrhythmia. Although rare, there is no current consensus on the optimal management of electrical shock-induced atrial fi brillation. CASE PRESENTATIONA previously well 40-year-old man presented to the emergency department after suffering an 11 000 volt DC electrical shock from overhead power lines through a portable crane which he was manipulating from the ground. He had initially been unable to remove his right hand, the entry point, from the controller as it had experienced tetanic contraction. After approximately 5 s he was thrown backwards onto turf. He denied loss of consciousness, head injury, shortness of breath or chest pain, but admitted to lethargy, a dull generalised headache and occasional palpitations. Paramedics had initially noted an irregular tachycardia.On examination, he was of athletic build and comfortable at rest. His right hand was generally mildly tender but was normal to inspection. His left great toe, the exit point, had a small blister on the lateral aspect which was painful to touch. There was no evidence of internal burns or compartment syndrome in the limbs or thorax. There were no signs of haemodynamic compromise. His pulse was irregularly irregular at a rate of 80 beats per min. His blood pressure was stable at 120/80 mm Hg. INVESTIGATIONSFull blood count, urea and electrolytes, prothrombin time and activated partial thromboplastin time, creatine kinase, troponin T and thyroid function tests were all within normal ranges. Chest radiography was normal. A targeted echocardiographic study demonstrated normal left ventricular systolic function. Electrocardiography undertaken before a routine minor surgical procedure 3 years previously had demonstrated sinus rhythm ( fi gure 1 ). His ECG on this occasion showed atrial fi brillation with a controlled ventricular rate ( fi gure 2 ). TREATMENTThe patient was transferred to the coronary care unit for cardiac monitoring. He was given a therapeutic dose of enoxaparin and simple analgesia. A 150 mg bolus of fl ecainide over 10 min, given 4 h after the initial injury, failed to restore sinus rhythm. An amiodarone infusion (300 mg over 1 h followed by a further 900 mg over 23 h), started 11 h after the initial injury, restored sinus rhythm 24 h after the initial injury. DC cardioversion had been intended had the amiodarone infusion failed to work. OUTCOME AND FOLLOW-UPThe patient's palpitations ceased on restoration of sinus rhythm. He was discharged home the same day. Follow-up in 1 month with a transthoracic echocardiograph was arranged. DISCUSSIONAtrial fi brillation is by far the most common persistent cardiac arrhythmia, with approximately 1-2 per cent of adults being affected at any one time. Incidence increases with age, with 9 per cent of those aged 80 or over being affected. 1 Other main risk factors for the development of atrial fi brilllation include hypertension and valve disease; less common causes include thyroid dysfunction, alcohol abuse and malignancy. 2 Electrocution as...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Electrocution-induced atrial fibrillation: a novel cause of a familiar arrhythmia

Langford

Dayer²

2012

Case Reports

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“…9 AF which is among the rare complications of electrical injury has also been documented in some case reports. 10,11 Arrowsmith et al evaluated 145 patients who suffered electrical injury in a centre over a five year period; cardiac arrest was seen only in 3% (four patients). AF was detected in only one patient and normal sinus rhythm was achieved after a single dose of intravenous digoxin infusion.…”

Section: Discussionmentioning

confidence: 99%

“…Most arrhythmias following electric shock include premature ventricular contractions, ventricular tachycardia, ventricular fibrillation, atrial tachycardia, atrial fibrillation, bundle branch block, and complete heart block. 1,2 These arrhythmias are more common with alternating current (AC) with higher voltage. AF after electrical shock is uncommon and that too requiring cardioversion is rare.…”

Section: Introductionmentioning

confidence: 99%

Atrial fibrillation following electric shock requiring cardioversion

et al. 2016

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Cardiac arrhythmias following electrical injury falls in a minority. Atrial arrhythmias including atrial fibrillation secondary to electrical shock are even more uncommon. This is a case report of AF requiring pharmacological cardioversion on a 41 year old female following an electrical shock. Initial attempt of electrical cardioversion had failed. Successful pharmacological cardioversion was achieved after 6 hours of amiodarone infusion (12-13 hours after the electric shock). Baseline electrocardiography showed normal pattern post cardioversion. Serum cardiac specific markers, electrolytes, thyroid function, chest x-ray and echocardiographic reports were all within normal limits.

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The Cardiovascular Effects of Environmental Traumas

1995

Cardiology Clinics

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Atrial Fibrillation Following Electrical Injury.

Cited by 9 publications

References 4 publications

Electrocution-induced atrial fibrillation: a novel cause of a familiar arrhythmia

Electrocution-induced atrial fibrillation: a novel cause of a familiar arrhythmia

Atrial fibrillation following electric shock requiring cardioversion

The Cardiovascular Effects of Environmental Traumas

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