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Cardioversion is a medical procedure by which an abnormally fast heart rate (tachycardia) or other cardiac arrhythmia is converted to a normal rhythm using electricity or drugs. Synchronized electrical cardioversion uses a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle , restoring the activity of the ...
Acute management is as for SVT in general. The aim is to interrupt the circuit. In the shocked patient, DC cardioversion may be necessary. In the absence of shock, inhibition at the AV node is attempted. This is achieved first by a trial of specific physical maneuvers such as holding a breath in or bearing down.
In-between episodes there is normal electrical conduction in the heart. During an episode of AVRT caused by PJRT, the accessory pathway conducts electrical activity from the ventricles directly back to the atria at the end of systole, which triggers the atria to contract, and the current to pass back to the ventricles again via the atrioventricular node (AV node); see diagram.
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In contrast to defibrillation, synchronized electrical cardioversion is an electrical shock delivered in synchrony to the cardiac cycle. [4] Although the person may still be critically ill, cardioversion normally aims to end poorly perfusing cardiac arrhythmias, such as supraventricular tachycardia. [1] [2]
Administered Ibutilide and converted to sinus rhythm but subsequently had an episode of Torsades de Pointes which required DC cardioversion back into sinus rhythm. In cardiology, T wave alternans (TWA) is a periodic beat-to-beat variation in the amplitude or shape of the T wave in an electrocardiogram (ECG or EKG). TWA was first described in 1908.
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