Laparoscopic cholecystectomy was performed in a 69-year old woman due to perforated acute gangrenous cholecystitis. After completion of the surgery, we administered 10 mg pyridostigmine for the reversal of neuromuscular block and 4 mg ondansetron for the prevention of nausea and vomiting. Twenty minute after arrival in the recovery room, atrial fibrillation and tachycardia occurred. Even with the continuous infusion of esmolol and then administration of digoxin, atrial fibrillation and tachycardia continued in the recovery room. After transfer to the general ward, the heart rate was gradually decreased, and next morning, we could find the atrial fibrillation disappeared.