Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Cardiac Arrest and Complete Heart Block: Complications after Electrical Cardioversion for Unstable Supraventricular Tachycardia in the Emergency Department

Adina Maria Marza
ORCID logo ,
Claudiu Barsac
* ,
Dumitru Sutoi
ORCID logo ,
Alexandru Cristian Cindrea
ORCID logo ,
Alexandra Herlo
,
Cosmin Iosif Trebuian
,
Alina Petrica
Version 1 : Received: 19 February 2024 / Approved: 19 February 2024 / Online: 19 February 2024 (14:52:55 CET)

A peer-reviewed article of this Preprint also exists.

Marza, A.M.; Barsac, C.; Sutoi, D.; Cindrea, A.C.; Herlo, A.; Trebuian, C.I.; Petrica, A. Cardiac Arrest and Complete Heart Block: Complications after Electrical Cardioversion for Unstable Supraventricular Tachycardia in the Emergency Department. J. Pers. Med. 2024, 14, 293. Marza, A.M.; Barsac, C.; Sutoi, D.; Cindrea, A.C.; Herlo, A.; Trebuian, C.I.; Petrica, A. Cardiac Arrest and Complete Heart Block: Complications after Electrical Cardioversion for Unstable Supraventricular Tachycardia in the Emergency Department. J. Pers. Med. 2024, 14, 293.

Abstract

Synchronous electrical cardioversion is a relatively common procedure in the emergency department (ED), often performed for unstable supraventricular tachycardia (SVT) or unstable ventricular tachycardia (VT). However, it is also used for stable cases resistant to drug therapy, which carry a risk of deterioration. In addition to the inherent risks linked with procedural sedation, there is a possibility of malignant arrhythmias or bradycardia, which could potentially result in cardiac arrest following this procedure. Here, we present a case of complete heart block unresponsive to transcutaneous pacing and positive inotropic and chronotropic drugs for 90 minutes, resulting in multiple cardiac arrests. The repositioning of the transcutaneous cardio-stimulation electrodes, one of them placed in the left latero-sternal position and the other at the level of the apex, led to immediate stabilization of the patient. Extubation of the patient was performed the following day, while full recovery and discharge within 7 days, after insertion of a permanent pacemaker.

Keywords

supraventricular tachycardia, cardioversion, unstable patient, complete heart block, ineffective pacing, cardiac arrest, advanced life support.

Subject

Medicine and Pharmacology, Emergency Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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