Case Report: PDF OnlyAcute Embolic Myocardial Infarction in a Patient with Paroxysmal Atrial Fibrillation Receiving Direct-current CardioversionLin, Tung-Chaoa, b; Hsieh, Yu-Chenga, c; Lee, Wen-Lienga, c; Lin, Yung-Kaia; Ting, Chih-Taia, c; Wu, Tsu-Jueya, c, *Author Information aCardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C. bDepartment of Internal Medicine, Long Cyuan Veterans Hospital, Pingtung, Taiwan, R.O.C. cDepartment of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C. *Correspondence to: Dr Tsu-Juey Wu, Cardiovascular Center, Taichung Veterans General Hospital, 160, Section 3, Chung-Kang Road, Taichung 407, Taiwan, R.O.C. E-mail: [email protected] Received: June 16, 2008; • Accepted: October 22, 2008. Journal of the Chinese Medical Association: March 2009 - Volume 72 - Issue 3 - p 146-149 doi: 10.1016/S1726-4901(09)70040-1 Metrics Abstract Coronary embolism with acute myocardial infarction (MI) following direct-current (DC) cardioversion of atrial fibrillation (AF) has rarely been reported. We present the case of a 34-year-old female with severe aortic regurgitation and highly symptomatic paroxysmal AF. Acute embolic MI occurred 4 days after DC cardioversion of AF, although there was no left atrial thrombus detected before this procedure. Insufficient anticoagulation therapy during the post-cardioversion period was the cause, leading to embolic MI. © 2009 by Lippincott Williams & Wilkins, Inc.