Carbon Monoxide-Induced Atrial Fibrillation: Unveiling the Cardiovascular Spectrum Through a Case Report and Systematic Review of Reported Cases

Division

North Florida

Hospital

North Florida Regional Medical Center

Document Type

Case Report

Publication Date

6-27-2025

Keywords

CO poisoning cardiovascular outcomes, carbon monoxide dysrhythmias, carbon monoxide toxicity, carbon monoxide-induced atrial fibrillation

Disciplines

Cardiovascular Diseases | Internal Medicine | Medicine and Health Sciences

Abstract

BACKGROUND: Carbon monoxide (CO) poisoning is a public health concern with cardiovascular consequences like arrhythmias. Atrial fibrillation (AF) has been sporadically linked to CO exposure.

CASE REPORT: A 72-year-old woman presented with gait imbalance, dizziness, and headache. ECG showed new-onset AF, while echocardiography and brain imaging were unremarkable. Her husband exhibited similar symptoms, raising suspicion of CO poisoning. Carboxyhemoglobin was 2.9%. She spontaneously reverted to sinus rhythm with normobaric oxygen therapy. Systematic Review: 7 cases of CO-induced AF (ages 21-82) were reviewed. Most patients were male 4 (57%) and did not have a history of cardiovascular diseases 6 (86%). The most common symptoms were headache and nausea, each occurring in 4 (57%) cases. Rapid ventricular response was observed in 6 (86%) cases, with most reverting to sinus rhythm.

CONCLUSION: CO poisoning increases dysrhythmia risk through hypoxia-induced myocardial changes and voltage-gated channel alterations. Greater awareness is needed regarding its cardiovascular implications.

Publisher or Conference

Oxford Medical Case Reports

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