Serial electrical cardioversion for refractory atrial fibrillation with rapid ventricular response post ablation

The authors present the case of a man in his 50s who arrived at the ED with palpitations and persistent tachycardia a month after undergoing catheter ablation (CA) for atrial fibrillation with rapid ventricular response, and a week after electrical cardioversion in our ED. He was once again successfully cardioverted in our ED. The unique aspect of this case is how refractory his case was.This case highlights the limitations of current AF management strategies in achieving durable rhythm control, particularly following ablation. It underscores the importance of timely follow-up, individualized treatment planning, and consideration of additional interventions such as repeat ablation or atrioventricular nodal ablation with pacemaker placement in refractory cases. Serial ECV can provide temporary relief but should be viewed as a bridge to more definitive therapy. Serial Electrical Cardioversion for Refractory Atrial Fibrillation with Rapid Ventricular Response Post Ablation.