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Challenges in Clinical Electrocardiography
June 13, 2011

Sustained Ventricular Fibrillation in a Conscious Patient—Discussion

Author Affiliations
 

JEFFREYTABASMDPAUL D.VAROSYMDGREGORY M.MARCUSMDNORAGOLDSCHLAGERMD

Arch Intern Med. 2011;171(11):974-975. doi:10.1001/archinternmed.2011.236

Although the arrhythmia persisted, no further ICD shocks were observed. The patient remained asymptomatic. Electrolyte analysis demonstrated a serum potassium level of 3.1 mEq/L (to convert to millimoles per liter, multiply by 1.0) and a magnesium level of 1.97 mEq/L (to convert to millimoles per liter, multiply by 0.5). Potassium replacement was undertaken. He was transferred to the intensive care unit and conscious sedation was administered. Forty-five minutes after arrhythmia onset, a biphasic 200-J external direct current shock converted the patient back to sinus rhythm. Diuresis was continued, and the patient was discharged from the hospital 1 week later without further arrhythmic complication.

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