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Postcardioversion ST-segment changes
  1. Andre Briosa e Gala,
  2. John Paisey
  1. Department of Cardiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Dr Andre Briosa e Gala, Department of Cardiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK; andre.gala{at}ouh.nhs.uk

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Clinical introduction

A 39-year-old man presented to the Emergency Department (ED) with a 10-hour history of palpitations but denied any chest pain, breathlessness or syncope. His medical history and family history were unremarkable. On admission, he was tachycardic with an irregularly irregular pulse at 180 beats/min. ECG showed atrial fibrillation with fast ventricular response (figure 1A). Bed-side transthoracic echocardiogram demonstrated a structurally normal heart. Chemical cardioversion was therefore attempted with intravenous flecainide. A postcardioversion 12-lead ECG was obtained (figure 1B).

Figure 1

(A) 12-lead ECG showing a narrow complex tachycardia with no discernible P-waves and irregular R–R intervals in keeping with atrial fibrillation. …

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Footnotes

  • Twitter @briosa_gala

  • Contributors ABeG conception and drafting of the manuscript. JP reviewed and edited the manuscript. All authors gave final approval prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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