Key result
Administration of a single 600mg oral loading dose of propafenone successfully restored sinus rhythm and resolved transient inferolateral ST-segment elevation in a patient with vagally mediated atrial fibrillation.
Case Report (n=1)
No
Transient ST-segment elevation in inferolateral leads during vagally mediated atrial fibrillation may be a benign phenomenon resulting from intense parasympathetic tone, resolving upon restoration of sinus rhythm.
Transient inferolateral ST elevation in vagally mediated AF may reflect intense vagal tone and resolve with sinus restoration; leaves open generalizability beyond single cases.
We report a case of vagally mediated atrial fibrillation on a young otherwise healthy man, with straight type ST-segment elevation in inferolateral leads that resolved a few hours after restoration of sinus rythm, a phenomenon that has never been previously reported. Even though no definite conclusion about the underlying mechanism of the ST-elevation can be made, this effect might probably be the result of intense parasympathetic tone and could be used to differentiate the causality.
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Constantinos Makrides (2012) conducted a case report in Vagally mediated atrial fibrillation (n=1). Propafenone was evaluated on Restoration of sinus rhythm and resolution of ST elevation. Administration of a single 600mg oral loading dose of propafenone successfully restored sinus rhythm and resolved transient inferolateral ST-segment elevation in a patient with vagally mediated atrial fibrillation.
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