Jornal de Toxicologia Clínica
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Paraquat-Induced Delayed Atrial Fibrillation

Chang Hun Lee, Young Min Hong, Kyung Pyo Kang, Won Kim, Sung Kwang Park and Sik Lee

Introduction: Paraquat (1, 1’-dimethyl-4, 4’-dipyridylium) is a nonselective potent herbicide. But, it can cause dramatic toxicity when misused. When ingested, paraquat is toxic to the lung, kidney, heart, central nervous system, and gastrointestinal tract, etc.

Case report: A patient visited to our emergency room after accidental ingestion of paraquat herbicide. The patient was treated with cyclophosphamide, steroid therapy, and hemoperfusion three times consecutively. His condition had improved. Shortly following treatment, the patient presented with palpitation and dizziness. His systolic blood pressure was 60 mmHg and electrocardiogram showed atrial fibrillation with a rapid ventricular response. Synchronized electrical cardioversion was provided and amiodarone was administered. The heart returned back to normal sinus rhythm and the vital signs stabilized.

Discussion: The heart is one of the most severely affected organs in paraquat poisoning and cardiac disturbances can lead to fatal complications. Therefore, it is important to delve deeper into the cardiac manifestations of paraquat poisoning for proper management.