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Electrical Injury-Induced Reversible High Degree AV block
Rhenata Dylan1, R.D Robin. H. Wibowo2
1
General Practitioner, 2Cardiologist at Department of Internal Medicin, Cibabat District General
Hospital, Cimahi, West Java
BACKGROUD: Heart is the most susceptible organs to electrical injury which may cause
abnormalities such as fatal arrhythmias, structural damage, and conduction disturbances. Electrical
accidents are commonly classified as either low voltage (<600 volts) or high voltage (>1000 volts).
Exposure to high voltage will cause ventricular asystole, whereas exposure to low voltage will
lead to Ventricular Fibrillation (VF).
OBJECTIVE: To report a rare case of electrical injury that induced reversible high degree
atrioventricular block
CASE REPORT: Mr. AM, 47 years-old male was complained combustion after high voltage
electrical injury. The input site of the current was in his both hand and the output site was in his
both leg. Physical examination was blood pressure 100/60 mmHg, respiration 20x/minute, heart
rate 40x/minute, JVP 5+2 cm H2O, grade II 20% combustion of hand, butt, and leg. ECG at
admission showed high degree atrioventricular block. Echocardiography showed mild left
ventricle diastolic dysfunction with preserved left ventricle systolic function 67,3%. The patient
was treated with inotropic and closely monitored. On the second day, The ECG changed to first
degree atrioventricular block and returned to normal sinus rhythm on the third day.
CONCLUSION: Reversible high degree atrioventricular block is a rare arrhythmic complication
of the electrical injury. Greater awareness is warranted for routine initial and follow up evaluation
of ECG abnormalities in the subset of electrical injury.
KEYWORD: electrical injury, atrioventricular block, reversible