Synchronised Cardioversion

Defibrillators are also used to transform tachyarrhythmias of an atrial or ventricular origin into sinus rhythm, by selecting the synchronised cardioversion mode. Reasons for emergency cardioversion include:

• persistent atrial fibrillation/flutter;

• poor response or undesirable side-effects from drug therapy;

• patient has become haemodynamically unstable due to a tachyarrhythmia;

• sustained supraventricular tachycardias which produce signs of cardiovascular distress (Trohman & Parillo 2000).

The aim of electrical cardioversion is to depolarise the myocardium, interrupt the tachyarrhythmia and so enable the sinoatrial node to regain control with a sinus rhythm. While the techniques and safety procedures for delivering the shock are similar in most respects, there are four major differences between defibrillation and cardioversion:

• synchronisation mode;

• selection of energy levels;

• complications.

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