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Ventricular fibrillation during electrical cardioversion of pre-excited atrial fibrillation

Department of Cardiology, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK

Correspondence to:
Correspondence to:
Dr Adlam;
davidadlam{at}doctors.org.uk

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.

Keywords: ventricular fibrillation; Wolff-Parkinson-White syndrome; cardioversion; atrial fibrillation