Şule Aydın TÜRKOĞLU, Sabri Onur ÇAĞLAR, Fatma ERDEM

NORMAL BASINÇLI HİDROSEFALİNİN NEDEN OLDUĞU PAROKSİSMAL ATRİYAL FİBRİLASYON OLGUSU

ÖZET Atriyal fibrilasyon (AF) klinik pratikte sık görülen bir ritim bozukluğudur. Yaş, diabetes mellitus, hipertansiyon, kalp yetmezliği, sigara, obezite, erkek cinsiyet, miyokard infarktüsü, valvüler kalp hastalığı, pulmoner hastalıklar ve hipertiroidi AF için risk faktörleridir. Mevcut bilgilerimize göre paroksismal AF ile normal basınçlı hidrosefali (NPH)birlikteliği daha önce bildirilmedi. Burada yeni başlangıçlı AF ile NPH birlikteliğini sunuyoruz. 53 yaşında bayan hasta acil sevişe 45 dakika önce başlayan çarpıntı şikayeti ile başvurdu. Çekilen elektrokardiyografi (EKG)si AF ile uyumluydu. Medikal kardiyoversiyon uygulandı. Medikal kardi- yoversiyon sonrası normal sinüs ritmi(NSR)ne dönmedi. Daha sonra 100 j ile bifazik elektriksel kardiyoversiyon uygulandı. Elektriksel kardiyoversiyon sonrası NSR elde edildi. Hastanın anamne- zinde bir haftadır olan yürüme güçlüğü mevcuttu. Nöroloji tarafından değerlendirilen hastaya be- yin MR istendi. MR ventrikülomegali ile uyumluydu. 25 mllik beyin omurilik sıvısının boşaltılması sonrası hastanın klinik bulguları normale döndü. Bu yüzden hekimler, NPHın AFye yol açabilece- ğini akılda bulundurmalıdır.

Case of Paroxysmal Atrial Fibrillation Induced by Normal Pressure Hydrocephalus

Atrial fibrillation (AF) is rhythm disorder which observed most common in clinical practice. Increasing age, diabetes mellitus, hypertension, heart failure, smoking, obesity, male gender, myocardial infarction, valvular heart diseases, pulmonary diseases and hyperthyroidism are risk factors for AF. To the best of our knowledge simultaneously of paroxysmal atrial fibrillation (PAF) and normal pressure hydrocephalus (NPH) has not been reported previously. We herein report the sudden onset of AF associated with NPH. A 53 year-old female was admitted to our emergency department complaining of palpitation during the past 45 minute. Electrocardiography (EKG) confirmed presence of (PAF). Medical cardioversion was planned. With medical cardioversion, her rhythm didn t return to the normal sinüs rhythm (NSR). Than biphasic anterior-posterior cardioversion was performed with DC at 100 J. NSR was achieved after DC cardioversion. According to her medical history, she has a difficulty in walking for one week. Patient was consulted by neurologist. On neurological examination, NPH was diagnosed. So physicians should keep in mind that NPH can cause to AF. Because of that, in emergency department if patient admit with complaining of palpitation, neurological diseases should be considered.

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