DC cardioversion Flashcards
1
Q
Define cardioversion.
A
The delivery of energy that is synchronised to the QRS complex
2
Q
Define defibrillation.
A
Asynchronous delivery of a shock randomly during the cardiac cycle.
3
Q
How is DC cardioversion carried out?
A
- To prevent VTE anticoagulation is required for 3-4 weeks before and after cardioversion OR exclude thrombus by echo
- Sedation administered by anaesthetist e.g. propofol
- Monitoring set up for ECG, BP, O2, CO2 end tidal
- Remove oxygen delivery device during shock delivery in case of electrical arcing causing fire
- Anterior posterior pads are placed
- Shock is delivered
4
Q
What energy levels are used for DC cardioversion in different conditions?
A
AF - 120-200J
Atrial flutter - 50-100J
VT with pulse - 100J
VF or pulseless VT - 200-360J
In obese patients higher energy may be required.
5
Q
What are the complications of DC cardioversion?
A
- ECG changes
- Hypotension due to sedation +/- vasodilation
- Skin irritation
- Arrhythmias
- Thromboembolism
