Paroxysmal atrial fibrillation developed during incomplete epidural anesthesia

Min Je Choi, Hye Won Shin, Sung Uk Choi, Ji Yong Park, Hye Won Lee, Hae Ja Lim, Suk Min Yoon, Seong Ho Chang

Research output: Contribution to journalArticlepeer-review


Atrial fibrillation (AF) is the most common sustained tachyarrhythmia, and occurs in organic heart disease such as rheumatic, atherosclerotic and hypertensive heart disease. In recent studies, the sympathetic and parasympathetic nervous systems have been shown to have important roles in initiating paroxysmal AF. We report here a patient who developed paroxysmal AF that might be a result of an imbalance of the sympathetic-parasympathetic systems due to epidural anesthesia, and that was potentiated by pain with inadequate analgesia. A 69-year-old woman was scheduled for operation of a right-sided ankle fracture. Twenty minutes after epidural drug injection, paroxysmal AF occurred. Even after intravenous administration of esmolol and digoxin, AF continued. After transfer to the intensive care unit, her heart rate gradually decreased and AF disappeared. During perioperative anesthetic management, the proper preoperative prevention and intraoperative treatment are needed in AF high-risk patients.

Original languageEnglish
Pages (from-to)S58-S61
JournalKorean journal of anesthesiology
Issue numberSUPPL.
Publication statusPublished - 2010 Dec
Externally publishedYes


  • Atrial fibrillation
  • Autonomic nervous system
  • Epidural anesthesia

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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