Anesth Pain Med.  2017 Jan;12(1):62-67. 10.17085/apm.2017.12.1.62.

Development of atrial flutter after induction of general anesthesia and conversion to atrial fibrillation: A case report

• Song JC
• Suk EH
• Cho JH
• Ju W
• Lee CS
• Lim YS

• KMID: 2369669
• DOI: http://doi.org/10.17085/apm.2017.12.1.62

Abstract

The most frequent perioperative cardiovascular event is cardiac dysrhythmia, defined as an abnormality of cardiac rate, rhythm or conduction. Although the occurrence of arrhythmia during the perioperative period is not uncommon, a case of newly developed perioperative atrial flutter which spontaneously converts to atrial fibrillation is rare. We report a case of atrial flutter that developed immediately after induction of general anesthesia, in a 70-year-old male patient who previously had a normal sinus rhythm. Atrial flutter changed spontaneously to atrial fibrillation after discharge to the recovery room. Dysrhythmia was unresponsive to drug therapy, and the atrial fibrillation disappeared after electric cardioversion.

Keyword

Atrial fibrillation; Atrial flutter; Cardioversion; General anesthesia

MeSH Terms

Aged
Anesthesia, General*
Arrhythmias, Cardiac
Atrial Fibrillation*
Atrial Flutter*
Drug Therapy
Electric Countershock
Humans
Male
Perioperative Period
Recovery Room

Figure

• 

  Fig. 1 Electrocardiogram taken one day before surgery. Regular sinus rhythm without arrhythmia was observed.

• 

  Fig. 2 Monitoring screen with lead II electrocardiography during anesthesia in operating room.

• 

  Fig. 3 Electrocardiogram taken immediately after arrival at recovery room. Atrial flutter with 2：1 atrioventricular block and saw-toothed P wave was observed.

• 

  Fig. 4 Electrocardiogram before electric cardioversion. Atrial flutter changed to atrial fibrillation with rapid ventricular responses (ventricular rate: 160–170 bpm).

• 

  Fig. 5 Electrocardiogram after electric DC cardioversion. Regular sinus rhythm was restored.

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