Abstract
The prevention of embolism is important in cases with defibrillation of atrial fibrillation. In chronic atrial fibrillation, there is some protocol for preventing the occurrence of embolisms, but no precise protocol in transient atrial fibrillation. A woman with transient atrial fibrillation was admitted to our hospital. She had the history of acute myocardial infarction, diabetes mellitus, hypertension and hyperlipidemia. Disopyramide phosphate (45 mg) was administrated intravenously and the rhythm was converted to sinus rhythm. After defibrillation, ST elevation on electrocardiography and the increase of the enzyme conserning with myocardium. In this patient, disopyramide phosphate was administrated later, but no electrocardiographic change were revealed. Coronary angiography revealed three vessel disease but not spastic. So, coronary embolism was strongly suspected. Some reports were seen about the electrocardiographic changes following the use of anti-arrhythmic agents, but the mechanism of those changes were due to conduction disturbance. Our case seems to be rare case with coronary embolism after pharmacological defibrillation of transient atrial fibrillation.
