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Atrial fibrillation associated with autonomic dysreflexia
Z M Pine1, S D Miller, J A Alonso
1Department of Rehabilitation Medicine, Columbia University, College of Physicians and Surgeons, New York, NY 10032.
American Journal of Physical Medicine & Rehabilitation
|October 1, 1991
Summary
Autonomic dysreflexia, a condition in individuals with spinal cord injuries, can trigger atrial fibrillation. This case highlights a potential link between these two serious health issues.
Area of Science:
- Cardiology
- Neurology
- Autonomic Nervous System Research
Background:
- Autonomic dysreflexia (AD) is a potentially life-threatening condition affecting individuals with spinal cord injuries (SCI) above the T6 neurological level.
- Atrial fibrillation (AF) is a common cardiac arrhythmia associated with increased risk of stroke and heart failure.
- Previous complications of AD have included neurological events and cardiac arrhythmias, but AF has not been frequently reported.
Observation:
- A 60-year-old male with C-5 incomplete quadriplegia experienced an episode of autonomic dysreflexia.
- During this episode, the patient developed atrial fibrillation.
- This case suggests a potential causal link between autonomic dysreflexia and the induction of atrial fibrillation.
Findings:
- Autonomic dysreflexia may induce atrial fibrillation through mechanisms involving altered cardiac autonomic tone.
- Atrial distention secondary to the hypertensive crisis of AD could also contribute to AF onset.
- The co-occurrence of AD and AF presents unique diagnostic and therapeutic challenges.
Implications:
- As the spinal cord-injured population ages, the incidence of AF associated with AD is expected to rise.
- Clinicians should be vigilant for AF in patients with SCI experiencing AD.
- Further research is needed to elucidate the precise mechanisms and optimize management strategies for this dual condition.