Key result
Adenosine and DC shock successfully restore sinus rhythm in 1:1 atrial flutter with ST depression.
Case Report (n=1)
No
Direct current cardioversion is effective for restoring sinus rhythm in hemodynamically unstable patients with atrial flutter and 1:1 AV conduction.
May support adenosine-facilitated low-energy cardioversion in select unstable atrial flutter cases; hypothesis-generating and requires prospective validation.
A 60-year-old lady presented to the emergency room with breathlessness, palpitations, dizziness and hypotension. The ECG showed narrow QRS complex tachycardia at a rate of 300 beats/min and downsloping ST segment depression. Following intravenous administration of adenosine, atrial flutter was confirmed and due to hemodynamic instability a direct current shock was delivered which restored sinus rhythm. The causes of such rapid ventricular rates in atrial flutter are discussed a propos with this case report.
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Pastromas et al. (2011) conducted a case report in Atrial flutter with 1:1 AV conduction and ST segment depression (n=1). Adenosine and direct current shock was evaluated on Restoration of sinus rhythm. In a 60-year-old woman with atrial flutter and 1:1 AV conduction accompanied by profound ST-segment depression, administration of adenosine followed by a 70-Joule DC shock successfully restored normal sinus rhythm without evidence of underlying coronary ischemia.
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