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Gepubliceerd in: Netherlands Heart Journal 4/2022

Open Access 25-02-2022 | Rhythm Puzzle – Question

Atrial fibrillation and what else?

Auteurs: S. M. van den Bogaard, F. E. Vervaat, P. H. van der Voort

Gepubliceerd in: Netherlands Heart Journal | Uitgave 4/2022

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A 56-year-old male with no pertinent medical history was referred to the emergency department with dyspnoea and fever due to COVID-19 pneumonia. At presentation oxygen saturation was 88%, necessitating supplemental oxygen and hospital admission. Due to a fast and irregular pulse, an electrocardiogram was recorded, which revealed atrial fibrillation (AF) but no other abnormalities (Fig. 1a). The patient experienced no symptoms associated with AF and the duration of AF was unknown. Metoprolol 50 mg twice daily was initiated with the aim of rate control. To achieve better rate control metoprolol was uptitrated to 100 mg thrice daily and digoxin was added. However, after higher doses of metoprolol and digoxin, rhythm monitoring showed repetitive bursts of wide complex tachycardia (Fig. 1b).
What is your diagnosis based on these electrocardiograms?

Answer

You will find the answer elsewhere in this issue.

Conflict of interest

S.M. van den Bogaard, F.E. Vervaat and P.H. van der Voort declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.
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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

Metagegevens
Titel
Atrial fibrillation and what else?
Auteurs
S. M. van den Bogaard
F. E. Vervaat
P. H. van der Voort
Publicatiedatum
25-02-2022
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 4/2022
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-022-01668-w

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