Cardioversion, Defibrillation, and Transcutaneous Pacing

Synchronized Cardioversion :
Purpose Cardioversion is the therapy of choice for termination of hemodynamically unstable
tachydysrhythmias. It may also be used to convert hemodynamically stable atrial fibrillation or
atrial flutter into normal sinus rhythm.
Definition Cardioversion refers to the process of restoring the heart's normal rhythm by applying a controlled
electric shock to the exterior of the chest.
Indication Synchronized cardioversion is recommended for termination of unstable paroxysmal
supraventricular tachycardia, atrial fibrillation, atrial flutter, and unstable ventricular tachycardia
with a pulse.
A counter-shock synchronized to the QRS complex allows for the electric current to be delivered
outside the heart’s vulnerable period.
Preparation Sedation

from
30°
to
Ste ☐

Synchronized cardioversion
g-
9
- Unstable tachytysrhythmia Paroxysmal : -

super ventral Tachycardia (150-300) , Ven trial Tack with

puke .

- Stables -
A - fib . A - flutter .

↳ Restoring normal
rhythm → controlled electric shock .

↳
synchronized QRS -

↳ * need sedition
shock - deer I. i.W.im
'

←
chary # as ←
enrage ←
sync ,_
←

Ed M @é six N
when

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Defibrillation:
Purpose The goal for defibrillation is to restore coordinated electric and mechanical pumping action, resulting in
restored cardiac output, tissue perfusion, and oxygenation.
Definition Defibrillation is a process in which an electrical device called a defibrillator sends an electric shock to the
heart to stop an arrhythmia resulting in the return of a productive heart rhythm
Indication External defibrillation is performed to eradicate life-threatening ventricular fibrillation or pulseless
ventricular tachycardia.

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Transcutaneous pacing:
Purpose The purpose of temporary transcutaneous cardiac pacing is to ensure or restore adequate heart rate and rhythm.
Definition
Indication Indications for transcutaneous pacing include the following:

④③-
① Asystolic cardiac arrest② , Symptomatic bradycardia, Temporary bridge in the presence of long-term pacemaker ⑦
⊖ @
failure, revision, or replacement before placement, Type II second degree atrioventricular (AV) heart block or third
degree AV heart block , Anesthesia-induced bradycardi, Emergent overdrive suppression or termination of
supraventricular and ventricular tachydysrhythmias before placement of temporary transvenous pacemaker.

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