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Introduction: It is well known that the incidence of atrial fibrillation increased with age over 65 years. However the role and incidence of atrial fibrillation in the admission in the regional hospital was not investigated. The aim of the study was to investigate the incidence, the commonest presenting features, associated cardiac conditions and the different types of atrial fibrillation which were admitted to our regional hospital during the last 10 month., Results: The incidence of atrial fibrillation was 13% (mean age: 71 years). The presenting features were dyspnea (28%), palpitation (25%), heart failure (19%), angina (10%), syncope/vertigo (5%), symptoms-free (13%). The most frequently associated cardiac condition was hypertension (64%). The patients were treated with the following antiarrhythmic drugs: beta-adrenergic blocker: 25%, propafenon (15%), propafenon and beta-adrenergic blocker (25%), sotalol (17%), amiodarone (13%), others (5%)., Conclusion: Nowadays atrial fibrillation is still a remarkable percentage of hospital admission. The most frequent clinical features were not the signs of arrhythmia but the signs of heart failure and ischaemic heart disease. In the treatment of atrial fibrillation the use of digoxin and class IA type antiarrhythmic agents were remarkably decreased and the use of class III, IC and beta-adrenergic blockers increased.

Introduction: High dose of angiotensin converting enzyme inhibitor is indicated in the treatment of heart failure and it is part of the treatment in the patients suffering from diabetes mellitus and nephropathy. The patients with preexisting renal insufficiency could have slowly elevated serum potassium level treated by angiotensin converting enzyme inhibitor., Patients: Seven acute admitted cases is presented with severe hyperkalaemia and life threatening arrhythmias caused by ACEI administration. Wide QRS accelerated rhythm was detected in two cases and bradyarrhythmias in five cases. Two patients died among the bradyarrhythmias., Conclusions: The authors call the attention of danger of high dose angiotensin converting enzyme inhibitor in patients with preexisting renal insufficiency and concomittant drugs elevating serum potassium level.