Acute Renal Failure and Hemolytic Anemia After Electrical Cardioversion In A Patient With Paroxysmal Atrial Fibrillation.

Case presentationA 65-year-old man presented to the clinic due to severe shortness of breath, orthopnea, easy fatigue, palpitations, and lower leg swelling last week.His medical history reported arterial hypertension, diabetes mellitus, mild heart failure, and mild ankylosing spondylitis.His medication included Nifedipine, Irbesartan, Metformin, and Methotrexate.The ECG in his medical examination before the 15th day had findings of benign hypertrophy of the left ventricle with sinus rhythm (Figure 1). On admission, his vital signs were• a body temperature of 36.6 degrees C,• a pulse rate of 120 beats per minute,• a respiration rate of 16 breaths per minute,• blood pressure of 114/75 mmHg, and AbstractA 65-year-old man presented progressively worsening shortness of breath due to acute decompensated heart failure with a first episode of atrial fibrillation (Afb) and rapid ventricular response.Due to his symptoms, it was decided to restore the sinus rhythm by applying electrical current cardioversion (EC).However, four days after discharge, the patient presented with anorexia, a recurrence of dyspnea, and weakness.ECG showed sinus rhythm.Laboratory tests revealed elevated serum urea and creatinine, decreased GFR, and severe anemia of hemolytic type.He remained non-oliguric.After a few days, the abnormal finding progressively resolved.On the occasion of this case report, we describe the literature data on the complications of EC in renal function and hematological profile.There is limited data on acute kidney injury occurrence and only one report on hemolytic anemia immediately after successful treatment of Afb by EC.