Cardioversion refers to the delivery of an electrical shock that is timed to the peak of the R wave on the EKG. This synchronization ensures that the electrical stimulation occurs only during the refractory period of the cardiac cycle minimizing the risk of iatrogenic arrhythmias.
Why must cardioversion be synchronized?
https://www.hrsonline.org/Patient-Resources/Treatment/Cardioversion. Accessed January 15, 2019. The reason a shock must be synchronized is that the cardiac cycle has both a vulnerable and a refractory period. The refractory period occurs during the QRS complex (see the image below).
What is the difference between defibrillation and synchronized cardioversion?
Unlike defibrillation, which is used in cardiac arrest patients, synchronized cardioversion is performed on patients that still have a pulse but are hemodynamically unstable. It is used to treat both hemodynamically unstable ventricular and supraventricular rhythms.
When should you avoid synchronized shock?
For cases where electrical shock is needed, if the patient is stable and you can see a QRS-t complex use (LOW ENERGY) synchronized cardioversion. If the patient is pulseless, or if the patient is unstable and the defibrillator will not synchronize, use (HIGH ENERGY) unsynchronized cardioversion (defibrillation).
Do you use synchronized cardioversion for Vtach?
Synchronized electrical cardioversion may also be used to treat stable ventricular tachycardia (VT, vtach) that does not respond to a trial of intravenous medications. It is also recommended for the treatment of the following arrhythmias: Supraventricular tachycardia (SVT) due to reentry. Atrial fibrillation (AF, afib
Is cardioversion always synchronized?
For cases where electrical shock is needed, if the patient is unstable, and you can see a QRS-t complex use (LOW ENERGY) synchronized cardioversion. If the patient is pulseless, or if the patient is unstable and the defibrillator will not synchronize, use (HIGH ENERGY) unsynchronized cardioversion (defibrillation).
What is synchronized electrical cardioversion?
Synchronized cardioversion is a procedure similar to electrical defibrillation in that a transthoracic electrical current is applied to the anterior chest to terminate a life-threatening or unstable tachycardic arrhythmia.
When do you use cardioversion vs defibrillation?
Defibrillation – is the treatment for immediately life-threatening arrhythmias with which the patient does not have a pulse, ie ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). Cardioversion – is any process that aims to convert an arrhythmia back to sinus rhythm.
How do you know if a defibrillator is monophasic or biphasic?
A monophasic waveform delivers electrical shocks in a single direction from one electrode to another. With a biphasic shock, the current travels in two phases. In the first phase, the current runs from the first electrode to the second electrode via the patient’s heart.
Do you shock Vtach with a pulse?
Under current resuscitation guidelines symptomatic ventricular tachycardia (VT) with a palpable pulse is treated with synchronised cardioversion to avoid inducing ventricular fibrillation (VF), whilst pulseless VT is treated as VF with rapid administration of full defibrillation energy unsynchronised shocks.
Is synchronized cardioversion appropriate for treating an unknown wide complex tachycardia?
Synchronized cardioversion is appropriate for treating wide complex tachycardia of unknown type. Prepare for synchronized cardioversion as soon as a wide complex tachycardia is detected.
Is defibrillation synchronized?
Defibrillation involves the delivery of a high-energy shock without the need to time the shock to the unstable rhythm (see the image below). In this example, the delivered shock is not synchronized with the ECG because the rhythm is unstable and there is no apparent QRS complex or T wave to avoid.
What do you do for V tach with Pulse?
Assess airway, breathing and circulation. In a pulseless patient, begin immediate CPR and attach AED or external defibrillator. If Vtach or Vfib, prepare for defibrillation. If pulse is present, attach EKG or defibrillator and evaluate rhythm.
When do you use synchronized vs unsynchronized cardioversion?
Defibrillation or unsynchronized cardioversion is indicated in any patient with pulseless VT/VF or unstable polymorphic VT, where synchronized cardioversion is not possible. Synchronized cardioversion is utilized for the treatment of persistent unstable tachyarrhythmia in patients without loss of pulse.
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