Direct Current Cardioversion for Lone Atrial Fibrillation in a Parturient with Placenta Accreta

K Kim, A Panico, P Melone and AS Bullough

Department of Anesthesiology, Loyola University Medical Center, USA
Department of Cardiology, Loyola University Medical Center, USA
Department of Obstetrics and Gynecology, Loyola University Medical Center, USA

^*Correspondance to: K Kim 

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Abstract:

Lone Atrial Fibrillation (AF) is a term used to describe AF occurring without clinical or echocardiographic evidence of cardiopulmonary disease including hypertension or an endocrine disorder. AF is rare in pregnancy however the cardiovascular physiological changes in pregnancy can promote arrhythmogenesis. Major concerns for a parturient with lone AF involve thromboembolic events and hemodynamic instability which would compromise the fetal-maternal unit. Clinical management of AF in pregnancy is the same as in a non-pregnant patient however faster intervention is required. American College of Cardiology, American Heart Association and European Society of Cardiology guidelines state management of AF considers rate control versus rhythm control by either chemical or Direct Current Cardioversion (DCCV). Synchronized DCCV is indicated if a patient becomes hemodynamically unstable as in our case. It has been successfully performed in all trimesters of pregnancy with a high success rate and with no evidence fetal harm. We report a case of preoperative lone AF treated with DCCV under general anesthesia for hemodynamic deterioration in a parturient who presented for a scheduled cesarean hysterectomy for a placenta accreta.

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Cite the Article:

K Kim, A Panico, P Melone, AS Bullough. Direct Current Cardioversion for Lone Atrial Fibrillation in a Parturient with Placenta Accreta. Ann Clin Case Rep. 2017; 2: 1280.