Cardioversion
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Through electricity or drug therapy, cardioversion converts heart arrhythmias to normal rhythms.
Similar to defibrillation, electrical cardioversion differs in that it uses much lower electricity levels, and is only performed on patients that are not currently in cardiac arrest. Pharmacologic cardioversion uses medication instead of an electrical shock.
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[edit] Electrical cardioversion
In the case of electrical shock, the patient lies on his or her back with one electrical conducting pad placed on the back and another on the upper chest. These pads are connected to an ECG machine which is also capable of delivering current. When the patient is sedated usually with IV Versed and Fentayl, a shock is delivered and the patient's ECG is checked for sinus rhythm. The shocks can be performed in conjunction with drug therapy until sinus rhythm is attained. Mulitple electrical shocks can cause burning of the epidermis. Protocols vary, but rarely are more than a few shocks delivered.
After the procedure, the patient is monitored for half an hour to ensure stability of the sinus rhythm. The risks are minimal and the patient feels very little during the procedure.
Electrical cardioversion is used to treat heart problems such as atrial fibrillation and atrial flutter. In the case of ventricular arrhythmias (such as [ventricular fibrillation] and [ventricular tachycardia]), a defibrillator is used; in most emergency settings the same appliance can be used for both cardioversion and defibrillation. The pace of the procedure for defibrillation is always fast owing to the life-threatening circumstances that it is used to treat. However, the speed used to initiate a cardioversion procedure may be nearly as quick as a defibrillation (as in the case of an unstable patient with atrial fibrillation), or slower, if the patient is stable and asymptomatic but has a potentially life-threatening dysrhythmia.
[edit] Pharmacologic cardioversion
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Various antiarrhythmic agents can be used to return the heart to sinus rhythm. Although this method is slower than electrical cardioversion, it is often attempted first for non-urgent atrial fibrillation.
