Cardioversion and Defib

8/8/2019 Cardioversion and Defib

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CardioversionCardioversion v.sv.s. Defibrillation. Defibrillation

Prepared by: Sarin Kurdian


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CardioversionCardioversion

y Cardioversion is the treatment for heart

rhythms that are irregular.

y During cardioversion, a special machine is

used to send electrical energy to the

heart muscle to restore normal rhythm.

y The procedure restores the normal heart

rate and rhythm, allowing the heart to

pump more effectively.


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When toWhen to cardiovertcardiovert??

y Mostly it is used to treat atrial fibrillation

or atrial flutter and ventricular

tachycardia.


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Atrial Flutter

Atrial Fibrillation

Ventricular

Tachycardia


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How isHow is cardioversioncardioversion performed?performed?

y In every critical situation there is enough

time to make sure of the plan.

y How long until anoxic brain injury?

3 to 6 minutes thats from 180 to 360

seconds.

y There is always all the time you need.


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y Make sure that you have everybody youneed.

y Make sure the patient is sedated by givingshort acting sedatives.

y Make sure the patient is oxygenated.

y Monitor heart rate and blood pressure.


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y Blood thinners can be giver prior to andafter the procedure for some time.

y TEE can be performed.

y Electrical shock is delivered to your chestwall through paddles or patches that stopsthe abnormal heartbeat and allows yourheart to resume a normal rhythm.


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InternalInternal cardioversioncardioversion

y Internal cardioversion may be used in

people whose heartbeat did not return to

normal after external cardioversion.Internal cardioversion works by delivering

an electrical shock through soft wires

(catheters) placed in the heart.


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y Cardioversion uses much lower

electricity levels to give the shock than

defibrillation.

y Timing of the shock correctly.

y Cardioversion we synchronize it with

QRS during V. tach.

y During V. fib. we defibrillate because we

dont have QRS to synchronize with.

Cardioversion v.s. DefibrillationCardioversion v.s. Defibrillation


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Cardioversion v.s. DefibrillationCardioversion v.s. Defibrillation

y Cardioversion is for organized kind of

rhythms.

y Defibrillation is for Disorganized kind of

rhythms.

yWhat you want to do is to send a fixed

amount of electrical energy along the

normal conduction path of the heart.


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How to know when is the rightHow to know when is the right

time to deliver the electric shock?time to deliver the electric shock?

y The defibrillator/cardioverter has the

ability to track the QRSs.

y This lets the machine figure out when its

safe to deliver the electric current.


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Important tipsImportant tips

y During cardioversion or defibrillation:

1. Dont shock a patient who is awake.

2. Dont forget to synchronize whencardioverting a-fib can be turned into v-fib this way.

3. Dont forget the conduction gel.

4. Dont forget to clear the bed.

5. Make sure that backup help is on the way.


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Important tips (Important tips (cntdcntd))

y After the procedure:

1. Monitor the patient carefully.

2. Check up on your patients labs.

3. Assess the patients skin.

4. Monitor 12 lead ECG

5. Monitor troponin and CPK levels6. Make sure the patient is taking

antiarrhythmic drugs


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Documents

Cardioversion and Defib