Atrial fibrillation with rapid ventricular response in a case with piperazine citrate intoxication: A rare manifestation Mohaddeseh Behjati, Mohammad Hashemi Department of Cardiology, Isfahan University of Medical Sciences, Isfahan, Iran Summary Background: Atrial fibrillation is one of the most vexing cardiovascular conditions and is induced by various factors. The emergence of new culprits for this expensive health problem results in its increased prevalence. Case Report: This is the case of a 29-year-old male whose chief complaints were fatigue, weakness, and palpita- tion. He was a previously healthy man who had been prescribed piperazine citrate for the treat- ment of oxyuriasis two days prior to admission. He became symptomatic after the unintentional ingestion of half of the bottle of piperazine citrate. On admission he was hypotensive with detect- able irregularly irregular pulse. Atrial fibrillation with rapid ventricular response was diagnosed by electrocardiography. The patient responded well to fluid therapy and rate control measures. Laboratory data were indicative of early stages of primary hypothyroidism, but the patient’s con- dition was not in favor of overt hypothyroidism. In echocardiographic evaluation, no clot or struc- tural heart disease was found. The patient was discharged with sinus heart rhythm. Conclusions: Atrial fibrillation with rapid ventricular response is a rare manifestation of piperazine citrate tox- icity. Piperazine citrate should be considered as a possible cause of atrial fibrillation in poisoning centers. key words: atrial fibrillation • rapid ventricular response • piperazine citrate Full-text PDF: http://www.amjcaserep.com/fulltxt.php?ICID=878253 Word count: 1096 Tables: — Figures: 3 References: 38 Author’s address: Mohaddeseh Behjati, Department of Cardiology, Isfahan University of Medical Sciences, Isfahan, Iran, e-mail: behjati@med.mui.ac.ir Received: 2009.08.07 Accepted: 2009.10.26 Published: 2009.11.16 201 © The American Journal of Case Reports, 2009; 10: 201-204 Case Report WWW. AMJCASEREP .COM