Carbon monoxide-induced atrial fibrillation: unveiling the cardiovascular Spectrum through a case report and systematic review of reported cases.

BACKGROUND: Carbon monoxide (CO) poisoning is a public health concern with cardiovascular consequences like arrhythmias. Atrial fibrillation (AF) has been sporadically linked to CO exposure. CASE REPORT: A 72-year-old woman presented with gait imbalance, dizziness, and headache. ECG showed new-onset AF, while echocardiography and brain imaging were unremarkable. Her husband exhibited similar symptoms, raising suspicion of CO poisoning. Carboxyhemoglobin was 2.9%. She spontaneously reverted to sinus rhythm with normobaric oxygen therapy. Systematic Review: 7 cases of CO-induced AF (ages 21-82) were reviewed. Most patients were male 4 (57%) and did not have a history of cardiovascular diseases 6 (86%). The most common symptoms were headache and nausea, each occurring in 4 (57%) cases. Rapid ventricular response was observed in 6 (86%) cases, with most reverting to sinus rhythm. CONCLUSION: CO poisoning increases dysrhythmia risk through hypoxia-induced myocardial changes and voltage-gated channel alterations. Greater awareness is needed regarding its cardiovascular implications.