Cardioversion
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
|
WikiDoc Resources for Cardioversion | |
|
Articles | |
|---|---|
|
Most recent articles on Cardioversion Most cited articles on Cardioversion | |
|
Media | |
|
Powerpoint slides on Cardioversion | |
|
Evidence Based Medicine | |
|
Clinical Trials | |
|
Ongoing Trials on Cardioversion at Clinical Trials.gov Trial results on Cardioversion Clinical Trials on Cardioversion at Google
| |
|
Guidelines / Policies / Govt | |
|
US National Guidelines Clearinghouse on Cardioversion NICE Guidance on Cardioversion
| |
|
Books | |
|
News | |
|
Commentary | |
|
Definitions | |
|
Patient Resources / Community | |
|
Patient resources on Cardioversion Discussion groups on Cardioversion Patient Handouts on Cardioversion Directions to Hospitals Treating Cardioversion Risk calculators and risk factors for Cardioversion
| |
|
Healthcare Provider Resources | |
|
Causes & Risk Factors for Cardioversion | |
|
Continuing Medical Education (CME) | |
|
International | |
|
| |
|
Businness | |
|
Experimental / Informatics | |
| Cardiology Network |
 Discuss Cardioversion further in the WikiDoc Cardiology Network |
| Adult Congenital |
|---|
| Biomarkers |
| Cardiac Rehabilitation |
| Congestive Heart Failure |
| CT Angiography |
| Echocardiography |
| Electrophysiology |
| Cardiology General |
| Genetics |
| Health Economics |
| Hypertension |
| Interventional Cardiology |
| MRI |
| Nuclear Cardiology |
| Peripheral Arterial Disease |
| Prevention |
| Public Policy |
| Pulmonary Embolism |
| Stable Angina |
| Valvular Heart Disease |
| Vascular Medicine |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Synchronized electrical cardioversion is the process by which an abnormally fast heart rate or cardiac arrhythmia is terminated by the delivery of a therapeutic dose of electrical current to the heart at a specific moment in the cardiac cycle.
Pharmacologic cardioversion uses medication instead of an electrical shock to convert the cardiac arrhythmia.
Synchronized electrical cardioversion
To perform synchronized electrical cardioversion two electrode pads are used, each comprising a metallic plate which is faced with a saline based conductive gel. The pads are placed on the chest of the patient, or one is placed on the chest and one on the back. These are connected by cables to a machine which has the combined functions of an ECG display screen and the electrical function of a defibrillator. A synchronizing function (either manually operated or automatic) allows the cardioverter to deliver a reversion shock, by way of the pads, of a selected amount of electrical current over a predefined number of milliseconds at the optimal moment in the cardiac cycle which corresponds to the R wave of the QRS complex on the ECG. Timing the shock to the R wave prevents the delivery of the shock during the vulnerable period (or relative refractory period) of the cardiac cycle, which could induce ventricular fibrillation. If the patient is conscious, various drugs are often used to help sedate the patient and make the procedure more tolerable. However, if the patient is haemodynamically unstable or unconscious, the shock is given immediately upon confirmation of the arrhythmia. When synchronized electrical cardioversion is performed as an elective procedure, the shocks can be performed in conjunction with drug therapy until sinus rhythm is attained. Multiple electrical shocks may cause burns of the epidermis at the pad sites. After the procedure, the patient is monitored to ensure stability of the sinus rhythm.
Synchronized electrical cardioversion is used to treat hemodynamically significant supraventricular (or narrow complex) tachycardias, including atrial fibrillation and atrial flutter. It is also used in the emergent treatment of wide complex tachycardias, including ventricular tachycardia, when a pulse is present. Pulseless ventricular tachycardia and ventricular fibrillation are treated with unsynchronized shocks referred to as defibrillation. Electrical therapy is inappropriate for sinus tachycardia, which should always be a part of the differential diagnosis.
Pharmacologic cardioversion
Various antiarrhythmic agents can be used to return the heart to normal sinus rhythm. Drugs like amiodarone, cardizem, and metoprolol are frequently given before cardioversion to decrease the heart rate, stabilize the patient and increase the chance that cardioversion is successful.
If the patient is stable, Adenosine may be administered first, as the medicine performs a sort of "chemical cardioversion" and may stabilize the heart and let it resume normal function on its own without using electricity.
See also
External links
- Cardioversion from the National Institutes of Health
- Pharmacological Cardioversion from the American Academy of Family Physicians
- Synchronized Electrical Cardioversion from eMedicine Online
- Cardioversion from the Heart Rhythm Society
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
