Lumbar Compression Fracture Caused by Cardioversion

Area of Science:

• Cardiology
• Medical Procedures

Background:

• Cardioversion is a globally prevalent and generally safe procedure for treating atrial fibrillation, with over 30,000 procedures annually in the US.
• Standard procedural risks include clot dislodgement, sedation effects, pain, burns, hypotension, dysrhythmias, and heart failure.
• Back pain is typically considered minor muscle soreness, and patient consents rarely mention specific back injuries.

Observation:

• A 46-year-old male with no prior back issues experienced sudden, severe back pain immediately after a synchronized cardioversion for atrial fibrillation.
• No falls or unusual events occurred during the procedure.
• Diagnostic evaluation revealed a new lumbar compression fracture as the cause of the patient's incapacitating pain.

Findings:

• This case highlights a rare but potentially underreported adverse effect of cardioversion: lumbar compression fracture.
• The fracture resulted in significant and prolonged pain, impacting the patient's quality of life for over six weeks.

Implications:

• Cardioversion, while effective for atrial fibrillation, carries a rare risk of serious spinal injury.
• Healthcare providers should counsel patients on the possibility of back injuries, including compression fractures, following cardioversion.
• Clinicians should consider lumbar compression fracture in the differential diagnosis for patients reporting back pain post-cardioversion.