Related Experiment Video
Updated: Oct 21, 2025
10:46
Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
13.5K
Hypoglossal Nerve Stimulator-Induced Neurapraxia Following Electrical Cardioversion for Atrial Fibrillation
Christian S Yacono1, Matthew C Hyman1
1Division of Cardiovascular Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
JACC. Case Reports
|September 2, 2021
Summary
Electrical cardioversion for atrial fibrillation can cause hypoglossal nerve stimulator-associated neurapraxia in patients with obstructive sleep apnea. This complication requires careful consideration during treatment planning.
Area of Science:
- Neurology
- Cardiology
- Sleep Medicine
Background:
- Obstructive sleep apnea (OSA) is increasingly treated with hypoglossal nerve stimulators (HNS).
- Atrial fibrillation (AF) is a common comorbidity in patients with OSA.
- Electrical cardioversion is a standard procedure for managing atrial fibrillation.
Observation:
- A case of neurapraxia associated with a hypoglossal nerve stimulator is presented.
- This complication occurred after electrical cardioversion for atrial fibrillation in an OSA patient.
Findings:
- Hypoglossal nerve stimulator implantation is associated with potential neurological complications.
- Electrical cardioversion may precipitate or exacerbate neurapraxia in patients with HNS.
Implications:
- Clinicians should be aware of the risk of HNS-associated neurapraxia after electrical cardioversion.
- Further research is needed to understand the mechanism and prevention of this complication.
- This case highlights the importance of a multidisciplinary approach in managing patients with OSA and AF.
Related Concept Videos
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
208
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
208
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
128
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
128
01:25Dysrhythmias VI: Management of Dysrhythmias
165
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
165
01:29Disturbances in Heart Rhythm
1.6K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
1.6K
01:23Cardiopulmonary Resuscitation III: AED Use
140
Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
140
01:12Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
1.4K
Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
1.4K