SACCM 304: Cardioversion Flashcards
What are the indications for cardioversion?
- when standard antiarrhythmic medications have failed to terminate an arrhythmia and the CO is severely compromised
- to terminate sustained tachyarrhythmias in an emergency setting
- lone atrial fibrillation
- supraventricular tachycardias
- monomorphic ventricular tachycardia
Do you need to administer antiarrhythmic drugs before cardioversion
technically cardioversion is indicated when medical management failed
BUT success rate of electrical cardioversion does not seem to improve with administration of antiarrhythmics before the procedure
Where do you apply the patches for cardioversion?
between 3rd and 6th rib on right and left hemithorax over the ventricles (if terminating Vtach) or the atria (if terminating SVT).
What phase of the ECG should the shokc of the cardioversion be synchronized to and why?
Explain why synchronous shock delivery is crucial for cardioversion and how this differs from defibrillation
synchronous shock delivery makes sure that shock delivered at the R wave - during the absolute refractory period of the myocytes
If shock was delivered during T wave - repolarizaiton period - high risk for inducing Vfib
defibrillation for Vfib is asynchronous, meaning shock is not synched to a certain phase of the ECG reading
What are potential complications of cardioversion?
- induction of Vfib
- thromboembolic event
- risks of GA
- skin burns
