Chlorine gas inhalation can induce acute atrial fibrillation in patients without underlying structural heart disease, which may be successfully managed with amiodarone.
Amiodarone may restore sinus rhythm after chlorine-induced AF; this single case leaves open efficacy, safety, and generalizability.
Inhalation of chlorine gas is reported to cause upper and lower respiratory tract irritation, bronchospasm, respiratory failure and tachycardia. 31-year-old male patient was exposed to hydrochloric acid and chlorine bleach inhalation for 20 minutes. 48 hours after exposure, he was admitted to the emergency room with the complaints of increasing dyspnea and palpitation. The patient was tachypneic and tachycardic. His electrocardiogram revealed an atrial fibrillation at a rate of 145/min. The hemodynamics of the patient were stable, his hemogram, cardiac enzymes and other biochemical parameter measurements were normal. The patient was diagnosed with acute atrial fibrillation, he did not have any organic cardiac disease, as he was unresponsive to the administration of parenteral propafenone and metoprolol, he was treated with amiodarone infusion. 13 hours after the administration of amiodarone, his heart converted back to sinus rhythm. His control electrocardiogram and echocardiogram did not reveal any other pathology. He was discharged with metoprolol maintenance treatment.
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Yüksel Doğan (2011) studied this question.
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