Refractory Hypotension after Cardioversion in a Patient with Atrial Fibrillation and Congestive Heart Failure

Ikuo Misumi; Tsuyoshi Honda; Hiroki Usuku; Akihiko Togashi; Takuya Kiyama; Ryusuke Tsunoda; Hiroyuki Obayashi; Hisayo Yasuda; Koichi Kaikita; Seiji Hokimoto; Hisao Ogawa

doi:10.2169/internalmedicine.55.6396

CASE REPORTS

Refractory Hypotension after Cardioversion in a Patient with Atrial Fibrillation and Congestive Heart Failure

Ikuo Misumi, Tsuyoshi Honda, Hiroki Usuku, Akihiko Togashi, Takuya Kiyama, Ryusuke Tsunoda, Hiroyuki Obayashi, Hisayo Yasuda, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa

Author information

Ikuo Misumi
Department of Cardiology, Kumamoto Saisyunsou Hospital, Japan
Tsuyoshi Honda
Department of Cardiology, Kumamoto Saisyunsou Hospital, Japan
Hiroki Usuku
Department of Cardiology, Kumamoto Saisyunsou Hospital, Japan
Akihiko Togashi
Department of Cardiology, Kumamoto Saisyunsou Hospital, Japan
Takuya Kiyama
Department of Cardiology, Japanese Red Cross Kumamoto Hospital, Japan
Ryusuke Tsunoda
Department of Cardiology, Japanese Red Cross Kumamoto Hospital, Japan
Hiroyuki Obayashi
Obayashi Shin-chi Clinic, Japan
Hisayo Yasuda
Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Japan
Koichi Kaikita
Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Japan
Seiji Hokimoto
Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Japan
Hisao Ogawa
Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Japan

Keywords: refractory hypotension, cardioversion, acidosis

JOURNAL OPEN ACCESS

2016 Volume 55 Issue 13 Pages 1747-1750

DOI https://doi.org/10.2169/internalmedicine.55.6396

Details

Abstract

A 63-year-old woman with atrial fibrillation visited our hospital due to decompensated heart failure. Because atrial fibrillation was considered a remarkable precipitating factor for heart failure, cardioversion was performed. After cardioversion, refractory hypotension and cardiopulmonary arrest occurred. An arterial blood gas analysis showed marked lactic acidosis. Chronic kidney disease, heart failure, sedatives, and hypoventilation might have contributed to refractory hypotension due to severe acidosis in this case.

Corresponding author

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