Citation

Zanoni S, Siefert JA, Darracq MA. J. Emerg. Med. 2013; 45(5): e149-51.

Affiliation

Department of Emergency Medicine, Navy Medical Center San Diego, San Diego, California.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.jemermed.2013.05.043

PMID

23937813

Abstract

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. Case Report: 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.

Language: en