A case of paroxysmal atrial fibrillation following low voltage electrocution

BMC Research Notes

Aruna Kulatunga¹  Thambyaiah Kandeepan¹  Mitrakrishnan Rayno Navinan¹ 

[1] National Hospital of Sri Lanka, Colombo, Sri Lanka

关键词: Spontaneous resolution;    Alternating current;    Electrocution;    Atrial fibrillation;   

Others  :  1141538
DOI  :  10.1186/1756-0500-6-384

 received in 2013-07-29, accepted in 2013-09-24,  发布年份 2013

【 摘 要 】

Background

Electrical injury may result in arrhythmias, however atrial fibrillation following low voltage electrocution is not a common occurrence.

Case presentation

A 70-year-old South-Asian woman with no prior history of cardiovascular disease presented following an accidental low voltage electrocution with loss of consciousness. On initial assessment she was found to be in atrial fibrillation with a moderate to rapid ventricular rate. Troponin I and 2D echo were normal. Transient rise in markers of muscle damage were noted. The arrhythmia resolved spontaneously without active intervention.

Conclusion

Loss of consciousness and the path of electrical conduction involving the heart may herald cardiac involvement following electrocution. Low voltage electrocution may cause cardiac insult. Conservative management may suffice in management of atrial fibrillation without cardiovascular compromise.

【 授权许可】

   
2013 Navinan et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Jensen PJ, Thomsen PE, Bagger JP, Norgaard A, Baandrup U: Electrical injury causing ventricular arrhythmias. Br Heart J 1987, 57:279-283.
• [2]Langford A, Dayer M: Electrocution-induced atrial fibrillation: a novel cause of a familiar arrhythmia. BMJ case reports 2012., 4(10)
• [3]Feinberg WM, Blackshear JL, Laupacis A, Kronmal R, Hart RG: Prevalence, age distribution, and gender of patients with atrial fibrillation: analysis and implications. Arch Intern Med 1995, 155:469-473.
• [4]Benjamin EJ, Levy D, Vaziri SM, D’Agostino RB, Belanger AJ, Wolf PA: Independent risk factors for atrial fibrillation in a population-based cohort: the Framingham heart study. JAMA 1994, 271:840-844.
• [5]Wehrmacher WH: ATrial fibrillation due to accidental electric shock. JAMA 1957, 165:349-351.
• [6]Cotoi S, Dragulescu SI: Idiopathic persistent atrial fibrillation precipitated by electrocution in a 40-year-old man. G Ital Cardiol 1974, 4:80-83.
• [7]Baruchin AM, Reisin L, Basevich R: Atrial fibrillation following electrical injury: a case report. Annals of MBC 1992., 5(2)
• [8]Shoenfeld P, Rupp J, Savage RW: Atrial fibrillation and electrical appliance injury. Mil Med 1991, 156:254-255.
• [9]Boggild H, Freund L, Bagger JP: Persistent atrial fibrillation following electrical injury. Occup Med (Lond) 1995, 45:49-50.
• [10]Morgan ZV, Headley RN, Alexander EA, Sawyer CG: Atrial fibrillation and epidural hematoma associated with lightning stroke. N Engl J Med 1958, 259:956-959.
• [11]Leiria TL, Pires LM, Kruse ML, De Lima GG: Struck by lightning: a case of nature-induced pre-excited atrial fibrillation. Circ Arrhythm Electrophysiol 2013, 6:e20-e21.
• [12]Taimur Z, Hussaini S: Atrial fibrillation in a commercial diver. Occup Med 2008, 58:144-146.
• [13]Electrical and lightning injuries. http://www.uic.edu/labs/lightninginjury/Electr&Ltn.pdf webcite
• [14]Guinard JP, Chiolero R, Buchser E, Delaloye-Bischof A, Payot M, Grbic A, Krupp S, Freeman J: Myocardial injury after electrical burns: short and long term study. Scand J Plast Reconstr Surg Hand Surg 1987, 21:301-302.
• [15]Purdue GF, Hunt JL: Electrocardiographic monitoring after electrical injury: necessity or luxury. J Trauma 1986, 26:166-167.
• [16]Lip GY, Apostolakis S: Atrial fibrillation (acute onset). Clin Evid 2011., 15
• [17]Nallasivan M, Appel RA, Welch WJ, Bauernfeind RA: Ventricular tachycardia due to bundle branch reentry: induction by spontaneous atrial premature beats. Am Heart J 1988, 116:552-555.
• [18]Thong T, McNames J, Aboy M, Goldstein B: Prediction of paroxysmal atrial fibrillation by analysis of atrial premature complexes. IEEE Trans Biomed Eng 2004, 51:561-569.
• [19]Wallmann D, Tuller D, Kucher N, Fuhrer J, Arnold M, Delacretaz E: Frequent atrial premature contractions as a surrogate marker for paroxysmal atrial fibrillation in patients with acute ischaemic stroke. Heart 2003, 89:1247-1248.
• [20]Hiss RG, Lamb LE: Electrocardiographic findings in 122,043 individuals. Circulation 1962, 25:947-961.
• [21]Gupta GB, Gupta SR, Somani PN, Agrawal BV: Atrial fibrillation with inferior wall myocardial ischaemia following lightning. J Assoc Physicians India 1988, 36:354-355.
• [22]Wander GS, Bansal RK, Anand IS, Arora S, Khurana SB, Chawla LS: Atrial fibrillation following electrical injury. Jpn Heart J 1992, 33:131-134.
• [23]Dronacharya L, Poudel R: Lightning induced atrial fibrillation. Kathmandu Univ Med J 2008, 6:514-515.