Electrical injury - induced atrial fibrillation

Introduction: Electrical injury can cause various cardiac dysrhythmias such as asystole, ventricular fibrillation, sinus tachycardia, and heart blocks. However, it rarely causes atrial fibrillation. Case report: Patient S.M, born in Nis in 1973, was admitted to the emergency department after receiving an electric shock (<600 V). He subsequently lost consciousness, fell down, and sustained back and head injuries. During the examination 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 atrial fibrillation. 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 hours, an electrocardiogram showed normal sinus rhythm. Conclusion: We report a rare case of an electrical injury-induced atrial fibrillation, which was converted to sinus rhythm by pocket therapy. Although most cases of an electrical injury-induced AF represent benign conditions which are self-limited, cardiac monitoring as a routine measure should be considered.