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A 63-year-old woman with atrial fibrillation visited our hospital due to decompensated heart failure. Because atrial fibrillation was considered a remarkable precipitating factor for heart failure, cardioversion was performed. After cardioversion, refractory hypotension and cardiopulmonary arrest occurred. An arterial blood gas analysis showed marked lactic acidosis. Chronic kidney disease, heart failure, sedatives, and hypoventilation might have contributed to refractory hypotension due todoi:10.2169/internalmedicine.55.6396 pmid:27374676 fatcat:vw4wisyghva5fn5oq72dwbkxnm