Why the study?
Does intravenous atropine cause ventricular fibrillation in a patient with complete AV block?
Does intravenous atropine cause ventricular fibrillation in a patient with complete AV block?
This case report highlights the rare but severe risk of ventricular fibrillation following intravenous atropine administration in a patient with complete AV block.
Answers are grounded in this paper and cite their sources.
IV atropine may precipitate VF in complete AV block; this case leaves the risk open for confirmation.
A 69-year-old black woman with complete AV block developed ventricular fibrillation following an IV injection of 1 mg of atropine sulphate. After a successful DC countershock, the ECG showed a polymorphous ventricular tachycardia which subsided spontaneously. Cardiac catheterization revealed a small left ventricular diverticulum and normal coronary arteries. This seems to be the first reported case of atropine-induced ventricular fibrillation in a patient with complete AV block. The fact that this occurred without previous change of the ventricular rate suggests that the adverse action of atropine was mediated through a mere vagolytic effect at the ventricular level.
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Lázzari et al. (1982) studied this question.
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