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Case Reports
. 2020 May 14;4(3):1-5.
doi: 10.1093/ehjcr/ytaa093. eCollection 2020 Jun.

Atrial pacing and administration of nifekalant hydrochloride for unstable atrial fibrillation: a case report

Daisuke Yakabe  1 , Masahiro Araki  1 , Kojiro Furukawa  2 , Toshihiro Nakamura  1
Affiliations
Case Reports

Atrial pacing and administration of nifekalant hydrochloride for unstable atrial fibrillation: a case report

Daisuke Yakabe et al. Eur Heart J Case Rep. .

Abstract

Background: Atrial fibrillation (AF) is a common arrhythmia in patients with hypertrophic cardiomyopathy (HCM) and can deteriorate haemodynamic status.

Case summary: We report a case of a 77-year-old woman with cardiogenic shock due to paroxysmal AF, complicated with HCM and aortic stenosis. Atrial fibrillation was successfully managed with temporary atrial pacing and administration of nifekalant hydrochloride without invasive mechanical circulatory support until surgery. Septal myectomy, aortic valve replacement, and pulmonary vein isolation were performed.

Discussion: This case suggests that atrial pacing and nifekalant may be safe and effective for rhythm control.

Keywords: Aortic stenosis; Atrial fibrillation; Cardiac pacing; Case report; Hypertrophic cardiomyopathy; Nifekalant hydrochloride.

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Figures

Figure 1
Figure 1
(A) Electrocardiogram and (B) chest radiograph at admission.
Figure 2
Figure 2
Echocardiography (A) before and (B) after surgery. These images show a parasternal long-axis view in systole. The diameter of the interventricular septum decreased from 22 to 15 mm after surgery (arrows).
Figure 3
Figure 3
Computed tomography scan. These images show the hypertrophic septal myocardium and calcified aortic valve in systole (left) and in diastole (right).
Figure 4
Figure 4
Measurements of pressure gradient between the left ventricle and aorta in each pacing mode. ECG, electrocardiography; LV, left ventricle; PG, pressure gradient.
Figure 5
Figure 5
Electrocardiographic tracing. Atrial fibrillation recurred soon after electrical cardioversion and caused persistent cardiogenic shock. Arrow shows the timing of atrial fibrillation recurrence.
None
See this image and copyright information in PMC

References

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