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Synchronized electrical cardioversion is used to treat hemodynamically unstable supraventricular (or narrow complex) tachycardias, including atrial fibrillation and atrial flutter. It is also used in the emergent treatment of wide complex tachycardias, including ventricular tachycardia, when a pulse is present.
Vagal maneuvers, such as the Valsalva maneuver, are often used as the initial treatment. [4] If not effective and the person has a normal blood pressure the medication adenosine may be tried. [4] If adenosine is not effective a calcium channel blocker or beta blocker may be used. [4] Otherwise synchronized cardioversion is the treatment. [4]
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]
This should be synchronized to the heartbeat if the waveform is monomorphic if possible, in order to avoid degeneration of the rhythm to ventricular fibrillation. [15] An initial energy of 100J is recommended. [15] If the waveform is polymorphic, then higher energies and an unsynchronized shock should be provided (also known as defibrillation ...
Cardioversion is either achieved pharmacologically or via the application of a shock synchronized to the underlying heartbeat. It is used for the treatment of supraventricular tachycardias. In elective cardioversion, the recipient is usually sedated or lightly anesthetized for the procedure. Defibrillation differs in that the shock is not ...
A person with poor vital signs, mental status changes, preexcitation, or chest pain often will go to immediate treatment with synchronized DC cardioversion. [28] Otherwise, the decision of rate control versus rhythm control using medications is made. This is based on several criteria that include whether or not symptoms persist with rate control.
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Treatment may be with specific physical maneuvers, medications, or, rarely, synchronized cardioversion. Frequent attacks may require radiofrequency ablation, in which the abnormally conducting tissue in the heart is destroyed. AVNRT occurs when a reentrant circuit forms within or just next to the atrioventricular node.
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