Paroxysmal Atrial Fibrillation and a Broken Heart: Anesthetic Goals for Cardioversion
A 46-year-old man with a history of paroxysmal atrial fibrillation status post-cardioversion in 2018, chronic myeloid leukemia, chemotherapy induced cardiomyopathy, and combined diastolic and systolic heart failure who previously declined LVAD placement presented to the ED with shortness of breath. Atrial fibrillation and global left ventricular hypokinesis with ejection fraction of 15-20% were revealed on electrocardiogram and transthoracic echocardiogram, respectively. After two days of medical management, the decision was made to cardiovert the patient under total intravenous anesthesia. With this case we will discuss the indications and contraindications of cardioversion, complications, anesthetic options, and therapies for refractory cases.
Nguyen A, Daklallah Y Soto RG. Paroxysmal atrial fibrillation and a broken heart: anesthetic goals for cardioversion. Paper presented at: The American Society of Anesthesiology Annual Meeting; 2021 Oct 8-12; San Diego, CA. Available at: https://www.abstractsonline.com/pp8/#!/9323/presentation/4919