A Rare Case of Cardioversion-Induced Ventricular Fibrillation in a 62 Year Old Male Due to Inappropriate Timing: A Case Report

•Atrial fibrillation (AF) is a common arrythmia of the heart due to the atria beating irregularly. AF has a national burden of over 30 million. AF is commonly managed in the outpatient clinic with pharmaceutical interventions. In a minority of cases, medications are unable to restore normal sinus rhythm of the heart, requiring further interventions such as cardiac ablation or trans-esophageal echocardiogram(TEE)/ cardioversion. This arrythmia can frequently leads to blood clots, stroke, and other cardiac complications. •This patient has recurrent paroxysmal AF for 3 years with resistance to multiple medication trials and presents for an outpatient TEE/cardioversion to restore normal sinus rhythm. Synchronized electrical cardioversion is a cardiac procedure to shock the heart to resolve arrythmias, but carries risks including skin irritation, stroke, heart damage, arrythmias such as ventricular fibrillation, and heart failure. This patient experienced an unsuccessful cardioversion, resulting in a new arrythmia of ventricular fibrillation following inappropriate timing of synchronized cardioversion. The purpose of this case report is to encourage awareness and further research on the complications of electric cardioversion. It is intended for others to learn the potential complications of a commonly performed procedure with a very low complication rate.