An unusual cause of atrial fibrillation: exposure to insecticides

Although there are many well-known cardiac results of insecticide poisoning, atrial fibrillation (AF) has not been reported as the result of insecticide intoxication.

Twenty-six-year-old male, complaining of nausea and vomiting, presented to the emergency department with a history of methomyl dust exposure. All physical examination findings were normal except irregular heart rate on cardiac auscultation. The electrocardiogram of the patient showed AF with normal ventricular response. Patient's acetylcholinesterase (ACE) level was 3,319 IU/L in presentation and pralidoxim use was seen unnecessary for the treatment. The patient's rhythm spontaneously returned to sinus rhythm 24 hr after the presentation and no cardiopulmonary pathology was found during the follow-up. The patient was discharged without symptoms.

AF is a rare complication of insecticide intoxication. In this case, treatment of symptoms was adequate until a normal sinus rhythm returned.