Key result
Direct cardioversion successfully reverted sudden intraoperative unstable atrial fibrillation to a normal rhythm in an elderly male patient with prosthetic heart valves undergoing open nephrectomy.
Why the study?
Patients with prosthetic heart valves present an anesthetic challenge, and atrial arrhythmias may occur in patients with preexisting cardiac conditions.
Case Report (n=1)
Direct cardioversion is an effective rescue strategy for intraoperative unstable atrial fibrillation in patients with complex cardiac history undergoing non-cardiac surgery.
Patient with prosthetic heart valves are a challenge to the anesthesiologist. Atrial arrhythmias may occur in a patient with preexisting cardiac condition. An elderly male patient with history of double valve replacement with rate controlled atrial fibrillation was taken up for open nephrectomy. Throughout the intraoperative period, hemodynamic instability was managed using inotropes. However, at the end of the procedure, patient had sudden episode of tachyarrhythmia with hypotension which was diagnosed as unstable atrial fibrillation (AF) and direct cardioversion was done which reverted the rhythm to normal. Patient was shifted to intensive care unit for observation and further management, where he was extubated after 24 hours.
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Jayakar et al. (2025) conducted a case report in Intraoperative unstable atrial fibrillation (n=1). Direct cardioversion was evaluated on Reversion to normal rhythm. Direct cardioversion successfully reverted sudden intraoperative unstable atrial fibrillation to a normal rhythm in an elderly male patient with prosthetic heart valves undergoing open nephrectomy.
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