Cardioversion: Difference between revisions

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{{Short description|Medical procedure to restore normal heart rhythm}}
[[File:Cardioversion.jpg|thumb|Cardioversion]]
{{Infobox medical procedure
Cardioversion is called defibrillation when it is done in an emergency to prevent death due to potentially fatal ventricular arrhythmias that can result in sudden cardiac arrest. Alternatively, your doctor can schedule cardioversion as a way to treat arrhythmias in the upper chambers of your heart called atrial fibrillation. If untreated, atrial fibrillation can increase your risk for stroke and heart failure.
| name        = Cardioversion
| image        = Cardioversion.svg
| caption      = Diagram of electrical cardioversion
| ICD10        = {{ICD10|Z|45|0|z|40}}
| ICD9        = {{ICD9|99.61}}
| MeshID      = D002316
}}


Scheduled cardioversion procedures may be done in a hospital or other health care facility by cardiologists, or doctors who specialize in the heart. While the procedure takes only a few minutes, it requires that you arrive a few hours before the procedure. To prepare, you will be given anesthesia through an intravenous (IV) line in your arm to make you fall asleep, and you will have electrodes placed on your chest and possibly your back. These electrodes will be attached to the cardioversion machine. The machine will record your heart’s electrical activity and send the shocks to your heart. When ready, the doctor will send one or more brief, low-energy shocks to your heart to restore a normal rhythm. You will not feel any pain from the shocks.
'''Cardioversion''' is a medical procedure used to restore a normal heart rhythm in patients experiencing certain types of abnormal heartbeats, known as [[arrhythmias]]. The procedure can be performed using either electrical shocks or medications.


You will need to stay for a few hours after your procedure. During this time, your health care team will monitor your heart rhythm and blood pressure closely and watch for complications. You will need a ride home because of the medicines or anesthesia you received. You may have some redness or soreness where the electrodes were placed. You also may have slight bruising where the IV line was inserted in your arm.
==Types of Cardioversion==


Although uncommon, cardioversion has some risks. It can cause or worsen life-threatening arrhythmias that will need to be treated. This procedure can cause blood clots to break away and travel from the heart to other tissues or organs and cause a stroke or other problems. Taking anticlotting medicines before and after cardioversion can reduce this risk.
===Electrical Cardioversion===
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[[File:Electrical cardioversion.jpg|thumb|Electrical cardioversion being performed.]]
{{dictionary-stub1}}
Electrical cardioversion involves delivering a controlled electric shock to the heart through electrodes placed on the chest. This shock momentarily stops the heart's electrical activity, allowing the heart's natural pacemaker to restore a normal rhythm. The procedure is typically performed under sedation to ensure patient comfort.
 
Electrical cardioversion is often used to treat [[atrial fibrillation]], [[atrial flutter]], and other supraventricular tachycardias. The synchronization of the shock with the QRS complex on the [[electrocardiogram]] (ECG) is crucial to avoid inducing [[ventricular fibrillation]].
 
[[File:LIFEPAK 20e Defibrillator and Monitor displaying synchronization with QRS complexes. (arrowheads).jpg|thumb|LIFEPAK 20e Defibrillator and Monitor displaying synchronization with QRS complexes.]]
 
===Pharmacological Cardioversion===
Pharmacological cardioversion, also known as chemical cardioversion, involves the use of antiarrhythmic medications to restore normal heart rhythm. Commonly used drugs include [[amiodarone]], [[flecainide]], and [[propafenone]]. This method is often used when electrical cardioversion is not feasible or as a first-line treatment in certain cases.
 
==Indications==
Cardioversion is indicated for patients with symptomatic arrhythmias that do not resolve spontaneously and are not controlled by medications. It is particularly useful in cases of atrial fibrillation and atrial flutter, where restoring sinus rhythm can alleviate symptoms and reduce the risk of [[stroke]].
 
==Risks and Complications==
While cardioversion is generally safe, it carries some risks, including:
* [[Thromboembolism]]: Patients with atrial fibrillation are at risk of forming blood clots, which can dislodge during cardioversion and cause a stroke. Anticoagulation therapy is often recommended before and after the procedure.
* Skin burns: The electrical shock can cause minor burns on the skin where the electrodes are placed.
* Arrhythmias: In rare cases, cardioversion can induce other arrhythmias, including ventricular fibrillation.
 
==Preparation and Procedure==
Before cardioversion, patients are typically evaluated with an ECG and may undergo [[transesophageal echocardiography]] to check for blood clots in the heart. Anticoagulation therapy is often initiated to reduce the risk of stroke.
 
During the procedure, the patient is sedated, and electrodes are placed on the chest. The defibrillator is set to deliver a synchronized shock, and the patient's heart rhythm is monitored throughout the process.
 
==Aftercare==
Following cardioversion, patients are monitored for any complications, and their heart rhythm is assessed to ensure the procedure was successful. Long-term management may include medications to maintain sinus rhythm and prevent recurrence of arrhythmias.
 
==Also see==
* [[Atrial fibrillation]]
* [[Defibrillation]]
* [[Electrocardiogram]]
* [[Antiarrhythmic agent]]
 
{{Cardiology}}
{{Medical procedures}}
 
[[Category:Cardiology]]
[[Category:Medical procedures]]

Latest revision as of 03:00, 11 December 2024

Medical procedure to restore normal heart rhythm
Diagram of electrical cardioversion
Pronunciation
Other names
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Uses
Complications
Approach
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Cardioversion is a medical procedure used to restore a normal heart rhythm in patients experiencing certain types of abnormal heartbeats, known as arrhythmias. The procedure can be performed using either electrical shocks or medications.

Types of Cardioversion[edit]

Electrical Cardioversion[edit]

Electrical cardioversion being performed.

Electrical cardioversion involves delivering a controlled electric shock to the heart through electrodes placed on the chest. This shock momentarily stops the heart's electrical activity, allowing the heart's natural pacemaker to restore a normal rhythm. The procedure is typically performed under sedation to ensure patient comfort.

Electrical cardioversion is often used to treat atrial fibrillation, atrial flutter, and other supraventricular tachycardias. The synchronization of the shock with the QRS complex on the electrocardiogram (ECG) is crucial to avoid inducing ventricular fibrillation.

LIFEPAK 20e Defibrillator and Monitor displaying synchronization with QRS complexes.

Pharmacological Cardioversion[edit]

Pharmacological cardioversion, also known as chemical cardioversion, involves the use of antiarrhythmic medications to restore normal heart rhythm. Commonly used drugs include amiodarone, flecainide, and propafenone. This method is often used when electrical cardioversion is not feasible or as a first-line treatment in certain cases.

Indications[edit]

Cardioversion is indicated for patients with symptomatic arrhythmias that do not resolve spontaneously and are not controlled by medications. It is particularly useful in cases of atrial fibrillation and atrial flutter, where restoring sinus rhythm can alleviate symptoms and reduce the risk of stroke.

Risks and Complications[edit]

While cardioversion is generally safe, it carries some risks, including:

  • Thromboembolism: Patients with atrial fibrillation are at risk of forming blood clots, which can dislodge during cardioversion and cause a stroke. Anticoagulation therapy is often recommended before and after the procedure.
  • Skin burns: The electrical shock can cause minor burns on the skin where the electrodes are placed.
  • Arrhythmias: In rare cases, cardioversion can induce other arrhythmias, including ventricular fibrillation.

Preparation and Procedure[edit]

Before cardioversion, patients are typically evaluated with an ECG and may undergo transesophageal echocardiography to check for blood clots in the heart. Anticoagulation therapy is often initiated to reduce the risk of stroke.

During the procedure, the patient is sedated, and electrodes are placed on the chest. The defibrillator is set to deliver a synchronized shock, and the patient's heart rhythm is monitored throughout the process.

Aftercare[edit]

Following cardioversion, patients are monitored for any complications, and their heart rhythm is assessed to ensure the procedure was successful. Long-term management may include medications to maintain sinus rhythm and prevent recurrence of arrhythmias.

Also see[edit]



Cardiovascular disease A-Z

Most common cardiac diseases

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