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Synchronized Cardioversion

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1. Iatrogenic Ventricular Fibrillation after Direct-Current Cardioversion of Preexcited Atrial Fibrillation Caused by Inadvertent T-Wave Synchronization (Full text)

Iatrogenic Ventricular Fibrillation after Direct-Current Cardioversion of Preexcited Atrial Fibrillation Caused by Inadvertent T-Wave Synchronization Direct-current cardioversion is an important means of managing arrhythmias. During treatment, carefully synchronizing energy delivery to the QRS complex is necessary to avoid ventricular fibrillation caused by a shock during the vulnerable period of ventricular repolarization, that is, a shock on the T wave. The presence of an accessory pathway (...) and ventricular preexcitation can lead to difficulty in distinguishing the QRS complex from the T wave because of bizarre, wide, irregular QRS complexes and prominent repolarization. We present the cases of 2 patients who had iatrogenic ventricular fibrillation from inappropriate T-wave synchronization during direct-current cardioversion of preexcited atrial fibrillation. Our experience shows that rapidly recognizing the iatrogenic cause of VF and immediate treatment with unsynchronized defibrillation can

2018 Texas Heart Institute Journal PubMed

2. Comparison of Direct Current Synchronized Cardioversion to Ibutilide-Guided Catheter Ablation for Long-Term Sinus Rhythm Maintenance After Isolated Pulmonary Vein Isolation of Persistent Atrial Fibrillation. (PubMed)

Comparison of Direct Current Synchronized Cardioversion to Ibutilide-Guided Catheter Ablation for Long-Term Sinus Rhythm Maintenance After Isolated Pulmonary Vein Isolation of Persistent Atrial Fibrillation. Use of the antiarrhythmic ibutilide after isolated pulmonary vein isolation (PVI) might distinguish atrial remodeling severity and cases requiring further substrate modification, thereby improving efficacy of persistent atrial fibrillation (AF) treatment. Ninety-six consecutive patients (...) with persistent AF were randomized after PVI to either direct current synchronized cardioversion (DCC group, n = 48) or 1 mg of intravenous ibutilide (ibutilide group, n = 48) followed by no further intervention if AF converted to sinus rhythm (SR) within 30 minutes (ibutilide conversion subgroup) or by complex fractionated atrial electrogram (CFAE) ablation until SR recovery or complete CFAE elimination (ibutilide nonconversion subgroup). With similarly distributed baseline characteristics and no serious

2017 American Journal of Cardiology

3. External Defibrillator Damage Associated With Attempted Synchronized Dual-Dose Cardioversion. (PubMed)

External Defibrillator Damage Associated With Attempted Synchronized Dual-Dose Cardioversion. The simultaneous use of 2 external defibrillators to administer either dual or sequential cardioversion or defibrillation for refractory cardiac arrhythmias is increasing in both the out-of-hospital and inhospital settings. Using 2 defibrillators to administer higher energy levels than can be achieved with a single defibrillator is considered off-label and is currently not part of published advanced (...) cardiac life support guidelines. We report the first case in which the use of dual-dose cardioversion was associated with external defibrillator damage. Because defibrillator damage, especially if undetected, jeopardizes patient safety and off-label medical product use may void the manufacturer's warranty, this case should urge users to proceed with caution when contemplating this technique.Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

2017 Annals of Emergency Medicine

4. Electrical Synchronized Cardioversion of Atrial Fibrillation

Electrical Synchronized Cardioversion of Atrial Fibrillation Electrical Synchronized Cardioversion of Atrial Fibrillation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure (...) Miscellaneous Abuse Cancer Administration 4 Electrical Synchronized Cardioversion of Atrial Fibrillation Electrical Synchronized Cardioversion of Atrial Fibrillation Aka: Electrical Synchronized Cardioversion of Atrial Fibrillation , Atrial Fib Synchronized Cardioversion , Atrial Flutter Synchronized Cardioversion From Related Chapters II. Indications with hemodynamic instability >48 hours on for >6 weeks (or cleared of atrial thrombus by TEE) <48 hours and no significant left atrial enlargement See

2018 FP Notebook

5. Synchronized Cardioversion

Synchronized Cardioversion Synchronized Cardioversion Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Synchronized Cardioversion (...) Synchronized Cardioversion Aka: Synchronized Cardioversion , Synchronized Shock II. Indications III. Protocol: Sedation prior to cardioversion Combination Protocol: and 0.15 to 0.2 mg/kg and : 1 mcg/kg/dose up to 50 mcg/dose every 3 minutes, titrating to effect Combination Protocol: and 1 mg IV every 3-5 minutes up to adequate sedation or to maximum 5 mg cummulative dose and 50 mcg increments risk Protocol Considered superior agent if patient stable Short induction Rapid awakening and recuperation Minimal

2018 FP Notebook

6. Beware Automated Synchronization for Cardioversion!

Beware Automated Synchronization for Cardioversion! Dr. Smith's ECG Blog: Beware Automated Synchronization for Cardioversion! Monday, February 2, 2015 This was provided by our electrophysiologist at the Hennepin Heart Center. The patient was having symptomatic atrial fibrillation and was to be cardioverted by a Zoll machine: Notice there is a Paced Rhythm. The small white arrows show each time the machine detects a QRS. This is also the location on the QRS complex where it is programmed (...) (Torsade) as the computer attempts to "synch", unsuccessfully. Surely someone's subjective finger sense of "perfusion" shouldn't be the determining factor here. Not sure if there's such scenario that if V-Tac if too fast that the machine could have the same trouble synchronizing and result in a delayed shock? It seems all monomorphic (unstable) V-tac should be treated with synchronized cardioversion, period, regardless of pulse, perfusion, or any other factor. Do you agree & practice as such? Curious

2015 Dr Smith's ECG Blog

7. An unstable wide complex tachycardia resistant to electrical cardioversion

. --The patient was given midazolam to prepare for electrical cardioversion --The BP dropped to 50-60 systolic after midazolam. --He was shocked multiple times with biphasic synchronized cardioversion at 200 J. The rhythm reportedly converted, then reverted to VT each time. --The patient was greatly distressed by the shocks, in spite of midazolam. --The patient was intubated and given another 12 mg of adenosine without change. --Another 150 mg bolus of amiodarone was given. --Mg 4 g IV was given --Ultimately (...) , and are not very wide). ---If you think it is SVT with aberrancy, adenosine is safe in VT and may be worth a try. In this case, the probability of SVT was very low. -- Synchronized electrical cardioversion is indicated, using safe and effective sedatives . If the patient is very unstable with altered mental status, cardioversion may be done without sedation. --Occasionally, the machine's algorithm cannot differentiate the QRS from the T-wave, and cannot synchronize, and therefore the shock does not fire at all

2017 Dr Smith's ECG Blog

8. Cardioversion of pre-excited atrial fibrillation leading to ventricular fibrillation- case report and review of literature. (PubMed)

Cardioversion of pre-excited atrial fibrillation leading to ventricular fibrillation- case report and review of literature. Pre-excited, fast conducting atrial fibrillation (AF) is a serious life-threatening arrhythmia that requires urgent pharmacological or electrical cardioversion. When anti-arrhythmic medications fail to restore sinus rhythm, biphasic, direct current (DC) cardioversion is required. Appropriate synchronization of the DC shock with the QRS is crucial, however not easily (...) achieved. Since the QRS-T complexes in pre-excited AF are severely distorted, the diagnosis of inaccurate synchronization may be overlooked. Here, we report a unique case where during electrical cardioversion of pre-excited AF with inappropriate synchronization on the T wave inadvertently resulted in ventricular fibrillation (VF), and review the literature.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 American Journal of Emergency Medicine

9. Sedative and Analgesic Effects of Entonox Gas Compared with Midazolam and Fentanyl in Synchronized Cardioversion. (Full text)

Sedative and Analgesic Effects of Entonox Gas Compared with Midazolam and Fentanyl in Synchronized Cardioversion. The purpose of this study was to determine if the Entonox gas could cause adequate analgesic and sedative effects in patients who need cardioversion. In this randomized not blinded clinical trial, the sedative and analgesic effects of midazolam and fentanyl were compared with Entonox. Eligible patients who need synchronized cardioversion because of dysrhythmia were randomly divided (...) , sedation duration and time to full recovery consciousness were shorter in the second group (P < 0.001). In the first group, seven patients needed additional doses to induce and maintain sedation. In addition, as a result of apnoea, four patients required airway support. None of them occurred in the second group. Entonox is a suitable medication in rapid cardioversion, as it has minimal side effects and adequate analgesic and sedative effects.

2015 Critical care research and practice PubMed

10. Efficacy and effects on cardiac function of radiofrequency catheter ablation vs. direct current cardioversion of persistent atrial fibrillation with left ventricular systolic dysfunction. (Full text)

Efficacy and effects on cardiac function of radiofrequency catheter ablation vs. direct current cardioversion of persistent atrial fibrillation with left ventricular systolic dysfunction. To evaluate the effect of catheter ablation vs. direct current synchronized cardioversion (DCC) in patients with persistent atrial fibrillation (AF) and left ventricular systolic dysfunction, and to define baseline features of patients that will get more benefit from ablation.From July 2013 to October 2014, 97 (...) LVEF increased (>20% or to over 55%) in 31 (54.39%) patients with worse baseline cardiac function and ventricular rate control.Catheter ablation relative to cardioversion of persistent AF with symptomatic heart failure yielded better 12-month SR maintenance and cardiac function. Compared with non-responders, patients with improved LVEF post-ablation had poorer ventricular rate control and cardiac function at baseline, suggesting a significant component of tachycardia-induced cardiomyopathy

2017 PLoS ONE PubMed

11. Synchronized Electrical Cardioversion (Treatment)

Synchronized Electrical Cardioversion (Treatment) Medscape Drugs & Diseases - Page Not Found Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. Page not found Sorry, the requested page could not be located. This may be the result of a broken link, expired bookmark, or mistyped URL. Please consider using the search field or links below to navigate

2014 eMedicine.com

12. Synchronized Electrical Cardioversion (Overview)

Synchronized Electrical Cardioversion (Overview) Synchronized Electrical Cardioversion: Overview, Indications, Contraindications Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTgzNDA0NC1vdmVydmlldw== processing (...) > Synchronized Electrical Cardioversion Updated: Nov 28, 2018 Author: Sean C Beinart, MD, MSc, FACC, FHRS; Chief Editor: Jose M Dizon, MD Share Email Print Feedback Close Sections Sections Synchronized Electrical Cardioversion Overview Overview Delivery of direct current (DC) shocks to the heart has long been used successfully to convert abnormal heart rhythms back to normal sinus rhythm. In 1775, Abildgaard reported using electricity to both induce and revive a hen from lifelessness. [ ] Beck was the first

2014 eMedicine.com

13. Synchronized Electrical Cardioversion (Follow-up)

Synchronized Electrical Cardioversion (Follow-up) Medscape Drugs & Diseases - Page Not Found Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. Page not found Sorry, the requested page could not be located. This may be the result of a broken link, expired bookmark, or mistyped URL. Please consider using the search field or links below to navigate

2014 eMedicine.com

14. Synchronized Electrical Cardioversion (Diagnosis)

Synchronized Electrical Cardioversion (Diagnosis) Medscape Drugs & Diseases - Page Not Found Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. Page not found Sorry, the requested page could not be located. This may be the result of a broken link, expired bookmark, or mistyped URL. Please consider using the search field or links below to navigate

2014 eMedicine.com

15. The Efficacy of Single Coil Defibrillation Leads for Internal Cardioversion of Atrial Fibrillation

to Arm Intervention/treatment Experimental: Internal Cardioversion Patients randomized to external cardioversion will undergo external synchronized cardioversion per institutional protocol. Procedure: Internal Cardioversion Internal Cardioversion with device maximum output shock from RV coil to Can versus external cardioversion per institutional protocol Active Comparator: External Cardioversion Patients randomized to internal cardioversion will have a maximum energy shock delivered from the device (...) The Efficacy of Single Coil Defibrillation Leads for Internal Cardioversion of Atrial Fibrillation The Efficacy of Single Coil Defibrillation Leads for Internal Cardioversion of Atrial Fibrillation - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove

2017 Clinical Trials

16. EEG Synchronized TMS Trial for Depression

EEG Synchronized TMS Trial for Depression EEG Synchronized TMS Trial for Depression - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. EEG Synchronized TMS Trial for Depression The safety and scientific (...) of Mental Health (NIMH) Information provided by (Responsible Party): Medical University of South Carolina Study Details Study Description Go to Brief Summary: Daily prefrontal TMS for depression, as developed by the PI, involves delivering TMS pulses to the prefrontal cortex and not assessing what the actual EEG phase is of the person's brain. In cardiology, in order to stimulate the heart effectively, one has to know the rhythm and phase of the heartbeat in order to perform cardioversion

2018 Clinical Trials

17. Wide Complex Tachycardia Refractory to Anti-dysrhythmics and Cardioversion.

, then 18 mg with no blocked p-waves or termination of tachycardia noted on rhythm strip. Nor was flutter revealed. Synchronized cardioversion was attempted with 150 joules —then 200 joules — then 200 joules w/ optimized placement of cardiac pads. The patient remained in this wide complex tachycardia but did have one capture beat noted transiently just after he was shocked. Patient was taken to the catheterization lab. In the cath lab, the patient was found to have patent grafts and no new lesion in his (...) Wide Complex Tachycardia Refractory to Anti-dysrhythmics and Cardioversion. Dr. Smith's ECG Blog: Wide Complex Tachycardia Refractory to Anti-dysrhythmics and Cardioversion. Wednesday, June 3, 2015 This was contributed by Rebecca Kornas, MD, one of our EM Residents. Edited and commented upon by Smith. A middle-aged male with a history of CAD and two vessel CABG and ischemic cardiomyopathy (EF 20%) presented to the emergency department (ED) after an out-of-hospital cardiac arrest. Paramedics

2015 Dr Smith's ECG Blog

18. Electrical Synchronized Cardioversion of Atrial Fibrillation

Electrical Synchronized Cardioversion of Atrial Fibrillation Electrical Synchronized Cardioversion of Atrial Fibrillation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure (...) Miscellaneous Abuse Cancer Administration 4 Electrical Synchronized Cardioversion of Atrial Fibrillation Electrical Synchronized Cardioversion of Atrial Fibrillation Aka: Electrical Synchronized Cardioversion of Atrial Fibrillation , Atrial Fib Synchronized Cardioversion , Atrial Flutter Synchronized Cardioversion From Related Chapters II. Indications with hemodynamic instability >48 hours on for >6 weeks (or cleared of atrial thrombus by TEE) <48 hours and no significant left atrial enlargement See

2015 FP Notebook

19. Synchronized Cardioversion

Synchronized Cardioversion Synchronized Cardioversion Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Synchronized Cardioversion (...) Synchronized Cardioversion Aka: Synchronized Cardioversion , Synchronized Shock II. Indications III. Protocol: Sedation prior to cardioversion Combination Protocol: and 0.15 to 0.2 mg/kg and : 1 mcg/kg/dose up to 50 mcg/dose every 3 minutes, titrating to effect Combination Protocol: and 1 mg IV every 3-5 minutes up to adequate sedation or to maximum 5 mg cummulative dose and 50 mcg increments risk Protocol Considered superior agent if patient stable Short induction Rapid awakening and recuperation Minimal

2015 FP Notebook

20. Comment on “Sedative and Analgesic Effects of Entonox Gas Compared with Midazolam and Fentanyl in Synchronized Cardioversion” (Full text)

Comment on “Sedative and Analgesic Effects of Entonox Gas Compared with Midazolam and Fentanyl in Synchronized Cardioversion” 27110396 2016 04 25 2018 11 13 2090-1305 2016 2016 Critical care research and practice Crit Care Res Pract Comment on "Sedative and Analgesic Effects of Entonox Gas Compared with Midazolam and Fentanyl in Synchronized Cardioversion". 3834891 10.1155/2016/3834891 Veloso Henrique Horta HH Evandro Chagas National Institute of Infectology, Oswaldo Cruz Foundation

2016 Critical care research and practice PubMed

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