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Lee WK, Shameem M, Ganti L, et al. Cardiac Arrest Following Treatment With Diltiazem for Atrial Fibrillation With Rapid Ventricular Response. Cureus. 2020;12(11):e11678doi: 10.7759/cureus.11678.
Lee, W. K., Shameem, M., Ganti, L., Banerjee, P. R., & Shivdat, J. (2020). Cardiac Arrest Following Treatment With Diltiazem for Atrial Fibrillation With Rapid Ventricular Response. Cureus, 12(11), e11678. https://doi.org/10.7759/cureus.11678
Lee, Woo Kyung, et al. "Cardiac Arrest Following Treatment With Diltiazem for Atrial Fibrillation With Rapid Ventricular Response." Cureus vol. 12,11 (2020): e11678. doi: https://doi.org/10.7759/cureus.11678
Lee WK, Shameem M, Ganti L, Banerjee PR, Shivdat J. Cardiac Arrest Following Treatment With Diltiazem for Atrial Fibrillation With Rapid Ventricular Response. Cureus. 2020 Nov 24;12(11):e11678. doi: 10.7759/cureus.11678. PMID: 33391915; PMCID: PMC7769750.
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Cureus. 2020 Nov 24;12(11):e11678. doi: 10.7759/cureus.11678.

Cardiac Arrest Following Treatment With Diltiazem for Atrial Fibrillation With Rapid Ventricular Response.

Cureus

Woo Kyung Lee, Masra Shameem, Latha Ganti, Paul R Banerjee, John Shivdat

Affiliations

  1. Emergency Medicine, Mercer University School of Medicine, Macon, USA.
  2. Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA.
  3. Emergency Medicine, Envision Physician Services, Plantation, USA.

PMID: 33391915 PMCID: PMC7769750 DOI: 10.7759/cureus.11678

Abstract

We present the case of a 43-year-old man with a history of atrial fibrillation and poor medical compliance who presented to the emergency department with palpitations for three hours. Electrocardiogram (ECG) revealed atrial fibrillation with rapid ventricular response at 119 beats per minute. Following administration of diltiazem 10 mg IV, the patient became bradycardic with a rate of 30 beats per minute and complete atrioventricular node block. A subsequent ECG revealed asystole, and the patient became unresponsive. Chest compressions were administered, and the rhythm changed to ventricular tachycardia. There was spontaneous return of circulation without any further intervention. The patient eventually converted to sinus rhythm and was started on anticoagulation to prevent a thrombotic event. He was discharged the next day with apixaban and propafenone.

Copyright © 2020, Lee et al.

Keywords: atrial fibrillation; av block; cardiopulmonary resuscitation; ventricular tachycardia

Conflict of interest statement

The authors have declared that no competing interests exist.

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