Koda Erik K
Banholzer Clinic, Malcolm Grow, Joint Base Andrews, MD, USA.
Am J Case Rep. 2020 Nov 10;21:e927064. doi: 10.12659/AJCR.927064.
BACKGROUND Cardioversion is a safe, commonly used procedure throughout the world. It is performed over 30 000 times per year in the United States, specifically for atrial fibrillation. Procedural risks from cardioversion include clot dislodgement, sedation effects, site pain, burns, hypotension, dysrhythmias, or heart failure. Generally, back pain is considered to be simple muscle soreness, and cardioversion consents therefore do not include discussion of back injuries. CASE REPORT A 46-year-old man with no prior back pain or injury history underwent a planned synchronized cardioversion for atrial fibrillation. He immediately reported new back pain following the procedure. No unusual event such as a fall occurred near the time of the procedure, but upon evaluation, he was found to have a new lumbar compression fracture that caused incapacitating pain for more than 6 weeks. CONCLUSIONS Cardioversion has been found to be a safe, effective treatment for atrial fibrillation. Adverse effects are generally minor, and the frequency of adverse effects appear to be low overall. The case reported here represents a rare, but possibly underreported adverse effect, namely, lumbar compression fracture due to cardioversion. Patients should be counseled on the possibility of back injury, even compression fracture, as a result of cardioversion. It would also be prudent to broaden the differential diagnosis possibilities should a patient complain of back pain after cardioversion.
心脏复律是一种在全球范围内安全且常用的治疗手段。在美国，每年进行超过30000次心脏复律，尤其是针对心房颤动。心脏复律的操作风险包括血栓脱落、镇静作用、穿刺部位疼痛、灼伤、低血压、心律失常或心力衰竭。一般来说，背痛被认为是单纯的肌肉酸痛，因此心脏复律知情同意书通常不包括对背部损伤的讨论。
一名46岁男性，既往无背痛或损伤史，因心房颤动接受了计划性同步心脏复律。术后他立即报告出现新的背痛。在操作前后未发生如跌倒等异常事件，但经评估发现他有一处新的腰椎压缩性骨折，导致剧痛超过6周。
心脏复律已被证明是治疗心房颤动的一种安全有效的方法。不良反应通常较轻，总体不良反应发生率似乎较低。此处报告的病例代表了一种罕见但可能未被充分报道的不良反应，即心脏复律导致的腰椎压缩性骨折。应告知患者心脏复律可能导致背部损伤，甚至压缩性骨折。如果患者在心脏复律后出现背痛，扩大鉴别诊断的范围也是谨慎之举。
