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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.
Otherwise synchronized cardioversion is the treatment. [4] Future episodes can be prevented by catheter ablation. [3] About 2.3 per 1000 people have paroxysmal supraventricular tachycardia. [5] Problems typically begin in those 12 to 45 years old. [3] [5] Women are more often affected than men. [3]
If the fast heart rate is poorly tolerated (e.g. the development of heart failure symptoms, low blood pressure or coma) then AVNRT can be terminated electrically using a cardioversion. In this procedure, after administering a strong sedative or general anaesthetic, an electric shock is applied to the heart to restore a normal rhythm. [8]
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]
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.
Tachycardia, also called tachyarrhythmia, is a heart rate that exceeds the normal resting rate. [1] In general, a resting heart rate over 100 beats per minute is accepted as tachycardia in adults. [1] Heart rates above the resting rate may be normal (such as with exercise) or abnormal (such as with electrical problems within the heart).
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