Fatal ventricular fibrillation during carotid sinus stimulation∗

Abstract

The third case of ventricular fibrillation (the first with autopsy) occurring during carotid sinus stimulation is reported. Although this patient received only moderate amounts of digoxin, had no obvious electrolyte derangement, and received carotid sinus stimulation for only a few seconds, a fatal outcome occurred. The heart was normal at necropsy. Although carotid sinus stimulation is an invaluable and usually a safe tool in the treatment and diagnosis of cardiac arrhythmias, it is suggested that caution be used in applying this maneuver to the critically ill patient who has received even modest amounts of cardiac glycosides.