-

Öz

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

Anahtar Kelimeler

• Atrial fibrillation; Normal pressure hydrocephalus; Electrocardiography

Normal Basınçlı Hidrosefalinin Neden Olduğu Paroksismal Atriyal Fibrilasyon Olgusu

Öz

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 kardiyoversiyon sonrası normal sinüs ritmi(NSR)'ne dönmedi. Daha sonra 100 j ile bifazik elektriksel kardiyoversiyon uygulandı. Elektriksel kardiyoversiyon sonrası NSR elde edildi. Hastanın anamnezinde bir haftadır olan yürüme güçlüğü mevcuttu. Nöroloji tarafindan değerlendirilen hastaya be­yin MR istendi. MR ventrikülomegali ile uyumluydu. 25 ml'lik beyin omurilik sıvısının boşaltılması sonrası hastanın klinik bulguları normale döndü. Bu yüzden hekimler, NPH'ın AF'ye yol açabilece­ğini akılda bulundurmalıdır.

Anahtar Kelimeler

• Atriyal fibrilasyon, Normal Basınçlı Hidrosefali, Elektrokardiyografi

Kaynakça

1. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991; 22(8):983-8.
2. Cairns JA, Connolly SJ. Nonrheumatic atrial fibrillation. Risk of stroke and role of antithrombotic therapy. Circulation. 1991;84(2):469-81.
3. Petersen P. Thromboembolic complications in atrial fibrillation. Stroke. 1990;21(1):4-13.
4. Hart RG, Pearce LA, Rothbart RM, McAnulty JH, Asinger RW, Halperin JL. Stroke with intermittent atrial fibrillation: incidence and predictors during aspirin therapy. Stroke Prevention in Atrial Fibrillation Investigators. J Am Coll Cardiol. 2000;35(1):183-7.
5. Benjamin EJ, Levy D, Vaziri SM, D’Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a population- based cohort: the Framingham Heart Study. JAMA. 1994;271(11):840–844
6. Dublin S, French B, Glazer NL, Wiggins KL, Lumley T, Psaty BM et al. Risk of new-onset atrial fibrillation in relation to body mass index. Arch Intern Med. 2006; 166(21):2322– 2328
7. Hakim S, Adams RD. The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics. J Neurol Sci.1965;2(4): 307–327.
8. Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM. Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery. 2005;57: S4–16.

9. European Heart Rhythm Association, Europea Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S,et al. “Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC),” European Heart Journal. 2010;12(10): 1360– 420
10. I. Klein and K. Ojamaa, “Thyroid hormone and the cardiovas- cular system,” The New England Journal of Medicine.2001.344(7):501-509
11. A. V. Samokhvalov, H. M. Irving, and J. Rehm, “Alcohol consumption as a risk factor for atrial fibrillation: a systematic review and meta-analysis,” European Journal of Cardiovascular Prevention and Rehabilitation. 2010;17(6): 706–712
12. A. J. Walkey, R. S. Wiener, J. M. Ghobrial, L. H. Curtis, and E. J. Benjamin, “Incident stroke and mortality associated with new-onset atrial fibrillation in patients hospitalized with severe sepsis,” Journal of the American Medical Association. 2011;306(20):2248–2255. ÇAĞLAR ve ark.
13. Hidrosefali ve Atrial Fibrilasyon Bozok Med J 2015;5(3):64-6