Cardioversion of Paroxysmal Arrhythmias

Abstract

Dr. Michael Cebrik, Junior Assistant Resident in Medicine, Jewish Hospital of St. Louis and Assistant in Medicine, Washington University School of Medicine: The first patient is a 68-year-old white woman who was admitted to Jewish Hospital for the second time on Aug 31, 1969, with a chief complaint of palpitations and a rapid heart rate. In September 1968, the patient had been hospitalized for similar complaints, at which time she was found to have atrial flutter with a 2:1 atrioventricular block and a ventricular rate of 140 beats per minute. Right bundle branch block, which had been present prior to this admission, was noted. The patient was treated with digoxin and warfarin sodium, and quinidine sulfate was added later. The cardiac rhythm varied from atrial flutter to atrial fibrillation with a ventricular response greater than 100 beats per minute. The quinidine effected a conversion to normal sinus rhythm and the