Instantly Converting Atrial Fibrillation into Sinus Rhythm by a Digital Rectal Exam on a 29-year-Old Male

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Instantly converting atrial fibrillation (AF) to sinus rhythm during a digital rhythm examination (such as an ECG) without any active intervention (like cardioversion or medication) is very rare, especially in a 29-year-old male. However, spontaneous conversion of AF can occur, particularly in young patients with paroxysmal atrial fibrillation (PAF) and no structural heart disease.

Key Points:
1. Paroxysmal AF can start and stop suddenly and may resolve spontaneously within minutes to hours.
2. The conversion to sinus rhythm during an ECG may simply coincide with the recording — giving the impression that the test caused the conversion.
3. Vagal maneuvers, stress, or even anxiety during the examination can sometimes influence rhythm in certain cases.
4. “Digital rhythm examination” itself (like an ECG) is diagnostic, not therapeutic — it doesn’t deliver energy or medication to affect rhythm.

Miracle for this young man as AF is not amenable to vagal stim.

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Could anyone explain in summarise manner. ?

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