Electrical shock-induced atrial fibrillation

Milovan Stojanović; Bojan Ilić; Marina Deljanin-Ilić; Stevan Ilić

doi:10.2298/VSP201020085S

Milovan Stojanović Institute for Treatment and Rehabilitation “Niška Banja”, Niška Banja, Serbia
Bojan Ilić Institute for Treatment and Rehabilitation “Niška Banja”, Niška Banja, Serbia
Marina Deljanin-Ilić Institute for Treatment and Rehabilitation “Niška Banja”, Niška Banja, Serbia
Stevan Ilić Clinic for Internal Diseases “CardioPoint”, Niš, Serbia

DOI: https://doi.org/10.2298/VSP201020085S

Keywords: anti-arrhythmia agents, atrial fibrillation, drug therapy, electric injuries, electrocardiography

Abstract

Introduction. An electrical injury can cause various cardiac arrhythmias, such as asystole, ventricular fibrillation, sinus tachycardia, and heart blocks. However, it rarely causes atrial fibrillation (AF). Case report. The 47-year-old patient was admitted to the Emergency Department after receiving an electric shock (< 600 V). He subsequently lost consciousness, fell, and sustained back and head injuries. During the examination, the heart rate was irregular but with no heart murmurs. There was an entry wound on the front of the left thigh and an exit wound on the front of the neck. An electrocardiogram showed newly appearing AF. The laboratory tests showed no pathological deviation, and focus cardiac ultrasound showed that contractile force was preserved with no wall-motion abnormalities and normal left atrium dimensions. The patient was administered low-molecular-weight heparin subcutaneously and propafenone (600 mg) orally. At follow-up after 24 hrs, the electrocardiogram showed normal sinus rhythm. Conclusion. We reported a rare case of an electricity shock-induced AF, which was converted to sinus rhythm with the help of drug therapy. Although most cases of electricity shock-induced AF represent benign conditions that are self-limited, cardiac monitoring as a routine measure should be considered.

References

1. Stojanović M, Deljanin-Ilić M, Ilić S, Krstić I, Mitić V, Simonovic D. Prevalence and echocardiographic characteristics of arterial hypertension in patients with atrial fibrillation: a single center study. J Biol Regul Homeost Agents 2019; 33(4): 1167‒70.

2. Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. ESC Scientific Document Group. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J 2021; 42(5): 373‒498.

3. Varol E, Ozaydin M, Altinbas A, Dogan A. Low-tension electrical injury as a cause of atrial fibrillation: a case report. Tex Heart Inst J 2004; 31(2): 186‒7.

4. Wander GS, Bansal RK, Anand IS, Arora S, Khurana SB, Chawla LS. Atrial fibrillation following electrical injury. Japan Heart J 1992; 33(1): 131‒4.

5. Langford A, Dayer M. Electrocution-induced atrial fibrillation: a novel cause of a familiar arrhythmia. BMJ Case Rep 2012; 2012: bcr0120125530.

6. Bøggild H, Freund L, Bagger JP. Persistent atrial fibrillation following electrical injury. Occup Med (Lond) 1995; 45(1): 49–50.

7. Jensen PJ, Thomsen PE, Bagger JP, Nørgaard A, Baandrup U. Electrical injury causing ventricular arrhythmias. Br Heart J 1987; 57(3): 279–83.

8. Waldmann V, Narayanan K, Combes N, Jost D, Jouven X, Marijon E. Electrical cardiac injuries: current concepts and management. Eur Heart J 2018; 39(16): 1459‒65.

9. Koumbourlis AC. Electrical injuries. Crit Care Med 2002; 30(11): S424‒30.

10. Akdemir R, Gunduz H, Erbilen E, Ozer I, Albayrak S, Unlu H, et al. Atrial fibrillation after electrical shock: a case report and review. Emerg Med J 2004; 21(6): 744‒6.