FAQ: When Should You Do Cardioversion?

Cardioversion is usually done to treat people who have atrial fibrillation or atrial flutter. These conditions occur when the electrical signals that normally make your heart beat at a regular rate don’t travel properly through the upper chambers of your heart.

What are the indications for cardioversion?

Indications for electrical cardioversion include the following:

• Supraventricular tachycardia (atrioventricular nodal reentrant tachycardia [AVNRT] and atrioventricular reentrant tachycardia [AVRT])
• Atrial fibrillation.
• Atrial flutter (types I and II)
• Ventricular tachycardia with pulse.

Is it necessary to have a cardioversion?

If you have an irregular heartbeat (you might hear it called arrhythmia, atrial fibrillation, or AFib), your doctor will probably suggest a treatment called cardioversion to help you get a normal rhythm back. If your heart beats too fast or unevenly, it can be dangerous.

How long do you have to be in AFib before cardioversion?

AF of ≥48 hours ‘ duration, or when the duration is unknown, requiring immediate cardioversion for hemodynamic instability: Anticoagulation should be administered as soon as possible and continued for 4 weeks after cardioversion.

What rhythms do you Cardiovert?

An electrical cardioversion, often referred to simply as a cardioversion, is a procedure used to treat an abnormal and rapid heart rhythm (also called a cardiac arrhythmia). The most commonly treated arrhythmia is atrial fibrillation. Another rhythm commonly treated with electrical cardioversion is atrial flutter.

What is the difference between cardioversion and defibrillator?

There is an important distinction between defibrillation and cardioversion: Defibrillation — Defibrillation is the asynchronous delivery of energy, such as the shock is delivered randomly during the cardiac cycle. Cardioversion — Cardioversion is the delivery of energy that is synchronized to the QRS complex.

When should you shock a patient?

Electrical cardioversion is used when the patient has a pulse but is either unstable, or chemical cardioversion has failed or is unlikely to be successful. These scenarios may be associated with chest pain, pulmonary oedema, syncope or hypotension.

Has anyone ever died during cardioversion?

With serial cardioversion 90% of the patients were kept in sinus rhythm for 5 years. Univariate analysis showed that a long duration of arrhythmia and impaired cardiac function were both related to poor outcome. During follow up 3 patients died of progression of heart failure and another 5 died suddenly.

Which is better cardioversion or ablation?

Conclusion: In patients with AF, there is a small periprocedural stroke risk with ablation in comparison to cardioversion. However, over longer-term follow-up, ablation is associated with a slightly lower rate of stroke.

How serious is a cardioversion?

A cardioversion is usually a safe procedure, and serious problems are unlikely. There is a small risk of blood clots that may travel from your heart to your body. Your medical team will be aware of this, and they’ll give you blood thinning medication to help prevent this from happening.

When is cardioversion not recommended?

Your healthcare provider may not want you to have cardioversion if you have minor symptoms. It also may not be recommended if you are elderly, if you have had AFib a long time, or if you have other major medical problems. Other treatments might be better for you, like heart rate control with medicines.

What is the life expectancy of a person with AFib?

Amongst the group of patients aged between 55-74 years, the 10 year mortality was 61.5% in men with AF compared to 30% in men without AF. Amongst women in a similar age group, the 10 year mortality was 57.6% in the AF group versus 20.9% in women without AF. Similar findings have been found from many other cohorts.

What is the 48 hour rule for cardioversion?

In 1995, practice guidelines recommended a limit of 48 hours after the onset of atrial fibrillation (AF) for cardioversion without anticoagulation. Whether the risk of thromboembolic complications is increased when cardioversion without anticoagulation is performed in less than 48 hours is unknown.

What are the 3 shockable rhythms?

Shockable Rhythms: Ventricular Tachycardia, Ventricular Fibrillation, Supraventricular Tachycardia.

How many joules do you use for cardioversion?

The recommended energy levels used to perform synchronized cardioversion vary from 50 to 200 joules. Recalling the specific energy level for a particular sub-type of unstable tachycardia is difficult, especially in an emergent situation.

How do you perform a cardioversion procedure?

To perform cardioversion, follow advanced cardiac life support guidelines:

1. Turn on the defibrillator.
2. Select the appropriate energy level.
3. Activate the synchronize mode by pressing the synchronize button.
4. Check to verify that the machine is correctly sensing the R wave.
5. Charge the machine to the ordered energy level.