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Postgrad Med J 2003;79:297-299 doi:10.1136/pmj.79.931.297
  • Case report

Ventricular fibrillation during electrical cardioversion of pre-excited atrial fibrillation

  1. D Adlam,
  2. T Azeem
  1. Department of Cardiology, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK
  1. Correspondence to:
 Dr Adlam;
 davidadlam{at}doctors.org.uk
  • Received 13 October 2002
  • Accepted 10 December 2002

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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