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Cardio Version

Cardioversion uses electrical shocks to restore normal heart rhythm in patients with arrhythmias such as atrial fibrillation, ventricular tachycardia, and supraventricular tachycardias. It is used for rhythm control in atrial fibrillation and is most effective when performed electively with anticoagulation to prevent blood clots. The procedure involves placing electrodes on the patient's chest, synchronizing a shock to the QRS complex, and delivering the shock at an energy level that depends on the type of arrhythmia in order to convert the rhythm to normal sinus rhythm.

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Anusha Verghese
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543 views2 pages

Cardio Version

Cardioversion uses electrical shocks to restore normal heart rhythm in patients with arrhythmias such as atrial fibrillation, ventricular tachycardia, and supraventricular tachycardias. It is used for rhythm control in atrial fibrillation and is most effective when performed electively with anticoagulation to prevent blood clots. The procedure involves placing electrodes on the patient's chest, synchronizing a shock to the QRS complex, and delivering the shock at an energy level that depends on the type of arrhythmia in order to convert the rhythm to normal sinus rhythm.

Uploaded by

Anusha Verghese
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Cardioversion

Uses
Decompensated rapid AF with a rapid ventricular response - eg, a hypotensive
patient, not responding to medical therapy.
VT with a pulse.
Supraventricular tachycardias including AF; not acutely urgent.
In cardioversion the shock has to be properly timed, so that it does not occur
during the vulnerable period, ie during the T wave. If this occurs then VT can be
triggered.

Atrial fibrillation
Cardioversion is used for rhythm control.
Medical treatments and cardioversion are of similar efficacy (unless permanent
AF).
Cardioversion of AF is associated with increased risk of thromboembolic disease
(TED); thus, anticoagulation is required for at least three weeks before and at
least four weeks afterwards.[9]
Some centres use transoesophageal echocardiogram during the procedure, in
order to look for thrombus, although a few patients still develop TED despite
negative results.
Sotalol or amiodarone can be given for at least four weeks prior to cardioversion
in patients who have had a previous failure to cardiovert or early recurrence of
AF.
Others advocate the use of medications such as sotalol and amiodarone to
maintain sinus rhythm after cardioversion.
How to cardiovert
Cardioversions are performed under general anaesthesia or sedation.
The majority of cardioversions are elective procedures; however, some are
performed when patients are acutely unwell with tachycardia - eg, chest pain,
breathlessness.
Turn on the machine and attach adhesive electrodes (efficacy may be better with
anterior-posterior electrodes).
Choose the energy level.
Get a clearly visible trace on the monitor - eg, using lead II.
Hit the 'synch' button - usually a blip or dot appears on the monitor, marking each
QRS complex.
Higher starting energy is associated with better success and fewer shocks.[12]
Broad complex tachycardia and atrial fibrillation: monophasic - begin with 200 J or
biphasic - 120-150 J.
Atrial flutter and narrow complex tachycardia: monophasic - 100 J or biphasic -
70-120 J.
Charge.
Ensure all is clear around the bed.
Discharge or shock - there may be a 1- to 2-second delay as the machine ensures
synchronisation
Check rhythm after the shock - if sinus rhythm, then stop; if not, then you may
need to deliver another shock at higher energy levels.
Look for burns afterwards and obtain a 12-lead ECG.

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