Key result
Beta-blockers and amiodarone prevent arrhythmic recurrences in an NSTEMI patient with couplet-triggered paroxysmal AF.
Case Report (n=1)
This case report highlights an unusual mechanism of paroxysmal atrial fibrillation triggered by monomorphic ventricular couplets in the setting of acute myocardial ischemia, which was successfully managed with beta-blockers and amiodarone.
May support considering beta-blockers plus amiodarone for ventricular couplet-triggered AF in NSTEMI; leaves open generalizability from this single case.
Atrial fibrillation is a common arrhythmia in patients suffering from acute myocardial infarction, however its pathophysiological mechanisms are not fully understood. We describe the unusual case of a 76-year old woman admitted for non-ST-segment elevation myocardial infarction, who developed multiple episodes of paroxysmal atrial fibrillation triggered by monomorphic ventricular couplets. Beta-blocking and amiodarone therapy resulted efficacious in preventing arrhythmic recurrences. We then discuss the possible arrhythmogenic mechanisms, with special emphasis on the unique electrophysiological, hemodynamic, cellular and anatomical milieu created by acute myocardial ischemia.
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Mattia et al. (2012) conducted a case report in Non-ST-segment elevation myocardial infarction and paroxysmal atrial fibrillation (n=1). Beta-blocking and amiodarone therapy was evaluated on Arrhythmic recurrences. Beta-blocking and amiodarone therapy successfully prevented arrhythmic recurrences in a patient with NSTEMI and paroxysmal atrial fibrillation triggered by ventricular couplets.
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