What are indications for synchronized cardioversion?
The most common indications for synchronized cardioversion are unstable atrial fibrillation, atrial flutter, atrial tachycardia, and supraventricular tachycardias. If medications fail in the stable patient with the before mentioned arrhythmias, synchronized cardioversion will most likely be indicated.
When do you use synchronized vs unsynchronized cardioversion?
Defibrillation or unsynchronized cardioversion is indicated in any patient with pulseless VT/VF or unstable polymorphic VT, where synchronized cardioversion is not possible. Synchronized cardioversion is utilized for the treatment of persistent unstable tachyarrhythmia in patients without loss of pulse.
What’s the difference between defibrillation and synchronized cardioversion?
Synchronized cardioversion delivers a low energy shock to the heart, whereas during defibrillation, a high-energy shock is delivered without the need to time the shock to the unstable rhythm.
What is synchronized and unsynchronized cardioversion?
Unsynchronized cardioversion or defibrillation is the delivery of a high-energy shock as soon as the button is pushed on defibrillator. By contrast, synchronized cardioversion (see Chap. 29) delivers a low-energy shock at the peak of the R wave in the cardiac (QRS) cycle.
Does synchronized cardioversion hurt?
Take time to obtain a 12-lead EKG if the patient is stable and there is any doubt about the patient’s rhythm. Since cardioversion is painful, the patient will need to be properly sedated with intravenous medication.
When should you use synchronized cardioversion?
Synchronized cardioversion is used to treat other arrhythmias, including atrial fibrillation (AF), atrial flutter and stable ventricular tachycardia when medications have failed to convert the rhythm, or when the patient is becoming unstable and the rhythm must be immediately terminated.
What are the 3 shockable rhythms?
Shockable Rhythms: Ventricular Tachycardia, Ventricular Fibrillation, Supraventricular Tachycardia.
Which is worse AFIB or VFIB?
Ventricular fibrillation is more serious than atrial fibrillation. Ventricular fibrillation frequently results in loss of consciousness and death, because ventricular arrhythmias are more likely to interrupt the pumping of blood, or undermine the heart’s ability to supply the body with oxygen-rich blood.
When should you avoid synchronized shock?
For cases where electrical shock is needed, if the patient is unstable, and you can see a QRS-t complex use (LOW ENERGY) synchronized cardioversion. If the patient is pulseless, or if the patient is unstable and the defibrillator will not synchronize, use (HIGH ENERGY) unsynchronized cardioversion (defibrillation).
How much do you shock for VFIB?
According to ACLS guidelines, an initial single shock at 360 joules is indicated for ventricular fibrillation (VF). The new guidelines have eliminated the three stacked shocks at 200>300>360 joules.
Do you shock VT with a pulse?
Unlike defibrillation, which is used in cardiac arrest patients, synchronized cardioversion is performed on patients that still have a pulse but are hemodynamically unstable. VT can also occur in the presence of a pulse; often, it is the precursor to VF.
Why do you Cardiovert an R wave?
External cardioversion Synchronization to an R or S wave prevents the delivery of a shock during the vulnerable period of cardiac repolarization when ventricular fibrillaiton (VF, vfib) can be induced.
What is R wave?
The R wave is the first upward deflection after the P wave and part of the QRS complex. If a right bundle branch block is present, there may be two R waves, resulting in the classic “bunny ear” appearance of the QRS complex. In this setting, the second R wave is termed “R’” or “R prime.”
What sedation is used for cardioversion?
The authors conclude that propofol is the superior sedative for emergency cardioversion of hemodynamically stable patients.
Are you awake during cardioversion?
Because the shock would be painful for a patient who is awake, an intravenous medication is given to sedate the patient. Patients are asleep during the cardioversion and most do not remember the procedure. It is not usually necessary to have a breathing tube (endotracheal tube) placed before the procedure.
How long does a cardioversion procedure take?
Cardioversion itself takes about 5 minutes. But the whole procedure, including recovery, will probably take 30 to 45 minutes. You may take an anticoagulant medicine before and after cardioversion.
What should you do before cardioversion?
You typically can’t eat or drink anything for about eight hours before your procedure. Your doctor will tell you whether to take any of your regular medications before your procedure. If you do take medications before your procedure, sip only enough water to swallow your pills.
How will I feel after cardioversion?
Your Recovery After the procedure, you may have redness, like a sunburn, where the patches were. The medicines you got to make you sleepy may make you feel drowsy for the rest of the day. Your doctor may have you take medicines to help the heart beat normally and to prevent blood clots.
What should you not do after cardioversion?
Cardioversion most often restores the heartbeat to normal. After the procedure, you may have redness where the patches were. (This may look like a sunburn.) Do not drive until the day after a cardioversion.