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A 70-year-old male patient with a history of persistent atrial fibrillation, asthma, amiodarone-induced hyperthyroidism, severe obstructive sleep apnea, and severe obesity (BMI of 49.38 kg/m2) presents to the Emergency Department for dyspnea at mild physical effort, asthenia, and fatigue that had progressively worsened during the past 4 weeks. His ECG ad admittance is presented in Fig. 1. Transthoracic echocardiography showed an LVEF of 48–50%, a nondilated left ventricle, moderate LA dilation (surface of 30 cm2), and mild pulmonary hypertension (sPAP of 45 mmHg). Since atrial fibrillation was considered at least partially responsive for the patient’s symptoms, chemical cardioversion was attempted with 300 mg of Flecainide orally. Twenty four hours after the administration of Flecainide, the patient presented an episode of palpitations and pre-syncope. A 12-lead ECG was recorded and is presented in Figs. 2 and 3.

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ECG 16

  • 章节

  • 发表日期：

    2025年

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  • Jacques Levy

摘要

A 70-year-old male patient with a history of persistent atrial fibrillation, asthma, amiodarone-induced hyperthyroidism, severe obstructive sleep apnea, and severe obesity (BMI of 49.38 kg/m2) presents to the Emergency Department for dyspnea at mild physical effort, asthenia, and fatigue that had progressively worsened during the past 4 weeks. His ECG ad admittance is presented in Fig. 1. Transthoracic echocardiography showed an LVEF of 48–50%, a nondilated left ventricle, moderate LA dilation (surface of 30 cm2), and mild pulmonary hypertension (sPAP of 45 mmHg). Since atrial fibrillation was considered at least partially responsive for the patient’s symptoms, chemical cardioversion was attempted with 300 mg of Flecainide orally. Twenty four hours after the administration of Flecainide, the patient presented an episode of palpitations and pre-syncope. A 12-lead ECG was recorded and is presented in Figs. 2 and 3.