Definition of Cardioversion

Cardioversion is a method to restore

.a rapid heart beat back to normal
Cardioversion is used in
persons who have heart rhythm
problems (arrhythmias), which can
.cause the heart to beat too fast

Cardioversion
Most elective or non-emergency
:Cardioversions are performed
To treat atrial fibrillation or atrial flutter to
regain heart rhythm.
To treat disturbances originating in the
upper
.Chambers (atria) of the heart

Cardioversion
Cardioversion is used in emergency
situations to correct a rapid abnormal
, rhythm associated with faintness
, low blood pressure, chest pain
difficulty breathing, or loss of
.consciousness

Types Of Cardioversion
Cardioversion can be "chemical" or
".electrical"
Chemical cardioversion: refers to the
use of antiarrhythmia medications
to restore the heart's normal rhythm.

Types Of Cardioversion
Electrical cardioversion : (also known
as " direct-current" or DC cardioversion);
is a procedure whereby a synchronized
electrical shock is delivered through the chest
wall to the heart through special electrodes
or paddles that are applied to the skin
.of the chest and back

The goals of the electrical

cardioversion
Is to disrupt the abnormal electrical circuit(s)
in the heart.
To restore a normal heart beat .

Pharmacologic Cardioversion
Cardioversion can be done using drugs
that are taken by mouth or given through
. an intravenous line (IV)
It can take several minutes to days for a
. successful cardioversion

Pharmacologic Cardioversion

If pharmacological cardioversion is done in

a hospital, your heart rate will be regularly
checked.

Cardioversion using drugs can be done

outside the hospital, but this requires close

follow-up with a cardiologist.

Pharmacologic Cardioversion

Blood thining medicines may be given

with electrical cardioversion to prevent
. clots from moving to the heart

Complications
:

Possible complications of cardioversion

are uncommon but may include

Worsening of the arrhythmias .

Blood clots that can cause a stroke or other organ damage,
bruising, burning or pain where the paddles were used.
Allergic reactions from medicines used in pharmacologic
cardioversion .

Equipment
Defibrillator with a synchronising button.
Emergency trolley with emergency drugs;
( lignocaine, atropine, and adrenaline ).

Oxygen mask, intubation equipment, airway

.

Monitor and continuous recording facilities.

Preparing for a
Cardioversion
Do not eat or drink for at least eight hours
prior to the procedure.
Take your regularly scheduled medications
the morning of the procedure unless your
medical practitioner has told you
otherwise .
Bring a list of all your medications with you.

Preparing for a
Cardioversion
Do not apply any lotions or ointments to
chest or back as this may interfere with the
adhesiveness of the shocking pads.
Do not drive yourself home after receiving
sedation anesthesia.

Preparing for a
Cardioversion
Do not operate a car, heavy machinery,
or make any important decisions.
Stop digoxin before 48 hours prior the
procedure.
Apply ointment to the area to reduce the
discomfort.

Outcome
The procedure will be terminated either by
a successful reversion to sinus rhythm or
when the medical officer determines that
.cardioversion will not revert the rhythm

Defibrillation
Is a medical technique used to counter the
onset of ventricular fibrillation, a common
cause of cardiac arrest, and pulseless
,ventricular tachycardia
In simple terms, the process uses an electric
shock to stop the heart arrhythmias, in the
hope that the heart will restart with rhythmic
.contractions

History Of Defibrillation
Defibrillation was invented in 1899 by Prevost
and Batelli, two Italian physiologists. They
discovered that electric shocks could convert
.ventricular fibrillation to sinus rhythm in dogs
The first case of a human life saved by
. defibrillation was reported by Beck in 1947

The Purpose Of
Defibrillation
Is to apply a controlled electrical
shock to the heart, which leads to
depolarization of the entire electrical
.conductive system of the heart

Types of Defibrillators
Internal Defibrillators
The device may be implanted directly in the
.user of the device
So it is known as an Impalantable
cardioverter-defibrillator or (much less
frequently) an internal cardiac defibrillator
. (ICD)
This type of defibrillator is designed to
provide immediate defibrillation to high-risk
.patients

Implantable Cardioversion
Defibrillation
An implantable cardioverter-defibrillator (often
called an ICD) is a device that briefly passes an
electric current through the heart. It is
"implanted," or put in your body surgically. It
includes a pulse generator and one or more
leads. The pulse generator constantly watches
your heartbeat.

Types of Defibrillators
Automated External defibrillator
(AEDs)
External defibrillators are typically used in
hospitals or ambulances, but are
increasingly common outside the
.medical areas
As automated external defibrillators
. become safer and cheaper

Methods Of Defibrillation
The shock is generally conducted through
the heart by two electrodes, in the form of
two hand-held paddles or adhesive
patches depending on the variety of the
.defibrillator

Methods Of Defibrillation
One electrode is placed on the right
side of the front of the chest just below
the clavicle.
The other electrode is placed on the left
side of the chest just below the pectoral
muscle of breast.

Methods Of Defibrillation
Open-chest defibrillators also exist, which
have electrodes in the form of two cupshaped paddles that surround the sides
.of the heart and shock it directly
Open-chest defibrillators generally
require less energy to operate due to
.direct contact with the heart

Methods Of Defibrillation
The number of attempts is in practice
limited to a series of three or four
.attempts at increasing energies
The likelihood of restoring normal heart
rhythm is much less in successive
.attempts

Differences Between
Cardioversion & Defibrillation
One major

difference between cardioversion

and defibrillation with the timing of the delivery
of electrical current .

Another major difference concerns the

circumstance defibrillation usually performed

as an emergency treatment .
Cardioversion is usually, but not always

planned procedure .

Procedure
The most well-known type of electrode is the
traditional metal paddle with an insulated
. handle
This type must be held in place on the
patient's skin while a shock or a series of
. shocks is delivered

Procedure
Steps

Place paddles so that they do not

touch pts clothing or bed linens or
not near direct oxygen supply.
Ensure monitor is attached to pat.
Do not charge the machine untill
ready to shock.

Procedure
Exert 25 pound pressure on the
paddle .
Ensure you and every body is free
of the pat.Inspect skin for burns.
Record the delivered energy.

Treatment
Shock may be delivered, but it is not
.regarded as the treatment of choice
Antiarrhthmic medications such as
, amiodarone, cordorone, lidocaine
magnesium, or pronestly are given if
.ventricular dysrhythmia persists

Treatment
The probability of a successful conversion is
very small according to the current
guidelines, in this situation, continued CPR in
order to improve the oxygenation of the heart
for a few minutes is preferred before
.defibrillation is attempted
.

Warning
As the nurse applies the shock this is just
a warning to everyone around to stay
away from the patient for risk of
.electrical shock