Atrial fibrillation (AF) is the most frequently observed arrhythmia in clinical practice. Many causative factors have been identified from well-known structural heart disease to less understood triggers. Both sympathetic and parasympathetic (vagal) stimuli are able to trigger paroxysms of AF. Vagally mediated AF is especially observed in young healthy subjects and especially during nights when the heart rate is considerably slow. Tachycardia induced AF is demonstrated and the possible mechanisms are explained. However, a case of bradycardia induced AF, thus far, hasnít been reported. Here we present a case of AF induced by severe bradycardia which was triggered by concomitant use of beta-blockers and diltiazem.
Credits: Gokhan Altunbas; Suleyman Ercan; Murat Sucu; Vedat DAvutoglu