Pulmonary embolism causing atrial fibrillation with slow ventricular response: a case report

BACKGROUND: Pulmonary embolism (PE) is a fatal condition, with a subsequent variety of complications. Although rare, the ensuing presentation of atrial fibrillation (AF) secondary to PE is evident in the literature. However, there has been no report of AF with slow ventricular response requiring a pacemaker as a complication of PE. CASE PRESENTATION: A 78-year-old obese female presented to the emergency room with new onset dyspnea. Computed tomography pulmonary angiogram revealed bilateral PE. Twenty-four hours later, the patient developed new onset AF with slow ventricular response. Therefore, a single chamber pacemaker was implanted. CONCLUSION: PE causing AF with slow ventricular response has not been reported or explained in the literature. The mechanism of this complication is yet to be understood and will require further investigation to explain this newly presented relationship.