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Synchronized Cardioversion

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1. External Defibrillator Damage Associated With Attempted Synchronized Dual-Dose Cardioversion. (Abstract)

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

2. 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 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 (...) one or more studies before adding more. The Efficacy of Single Coil Defibrillation Leads for Internal Cardioversion of Atrial Fibrillation The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03164395 Recruitment Status : Completed First Posted : May 23, 2017 Last Update Posted : March 22, 2019 Sponsor

2017 Clinical Trials

3. Static automated external defibrillators for opportunistic use by bystanders

by ventricular fibrillation (VF) 3 . VF can be abolished by electrical defibrillation whereby the application of an electrical shock to the chest depolarises the heart and enables normal heart rhythm to resume. A cardiac arrest of non-cardiac origin may be due to other medical causes (e.g. anaphylaxis, asthma, exsanguination), trauma, drug overdose, drowning, electrocution, asphyxia (airway obstruction, hanging, or strangulation) 1, 2 . Immediate cardiopulmonary resuscitation (CPR) of an OHCA victim provides (...) , 5 , this rhythm gradually deteriorates to asystole, and only 25 to 50% of them still have VF by the time the first electrocardiogram is monitored 2 . “Shockable rhythm” refers to VF (or pulseless ventricular tachycardia) as the first monitored rhythm. In contrast to asystole, these rhythms are treatable by electric defibrillation. 6 Static automated external defibrillators for opportunistic use by bystanders KCE Report 294 The time dependency of shockability has been demonstrated in a recent UK

2017 Belgian Health Care Knowledge Centre

4. Iatrogenic Ventricular Fibrillation after Direct-Current Cardioversion of Preexcited Atrial Fibrillation Caused by Inadvertent T-Wave Synchronization Full Text available with Trip Pro

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 (...) 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

2018 Texas Heart Institute Journal

5. Atrial electrogram quality in single-pass defibrillator leads with floating atrial bipole in patients with permanent atrial fibrillation and cardiac resynchronization therapy Full Text available with Trip Pro

Atrial electrogram quality in single-pass defibrillator leads with floating atrial bipole in patients with permanent atrial fibrillation and cardiac resynchronization therapy Many patients receiving cardiac resynchronization therapy (CRT) suffer from permanent atrial fibrillation (AF). Knowledge of the atrial rhythm is important to direct pharmacological or interventional treatment as well as maintaining AV-synchronous biventricular pacing if sinus rhythm can be restored. A single pass single (...) -coil defibrillator lead with a floating atrial bipole has been shown to obtain reliable information about the atrial rhythm but has never been employed in a CRT-system. The purpose of this study was to assess the feasibility of implanting a single coil right ventricular ICD lead with a floating atrial bipole and the signal quality of atrial electrograms (AEGM) in CRT-defibrillator recipients with permanent AF.Seventeen patients (16 males, mean age 73 ± 6 years, mean EF 25 ± 5%) with permanent AF

2018 Indian pacing and electrophysiology journal

6. 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. (Abstract)

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 Controlled trial quality: uncertain

7. 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

8. Synchronized Cardioversion

Adult Narrow regular ( , ) Initial: 50-100 J (monophasic or biphasic) Narrow irregular ( ) See Initial Monophasic: 200 J synchronized (up to 360 J synchronized) Initial Biphasic: 150 J synchronized (up to 200 J synchronized) Consider 150 mg prior to cardioversion if stable Anecdotal evidence of improved success in electrical cardioversion of or indications of unknown duration or >48 hours (emergent, unstable cases requiring immediate cardioversion) or High risk of (e.g. prior TIA or CVA, , ) See (...) Wide regular ( ) Initial: 100 J (monophasic or biphasic) Wide irregular (non-synchronized) VI. Precautions: Digoxin Do not use electrical cardioversion in (risk of malignant ventricular arrhythmia) Modified electrical cardioversion dosing in patients on Start at 10-20 Joules biphasic Increase in 10-20 Joule increments until cardioversion Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Synchronized Cardioversion." Click

2018 FP Notebook

9. Endocardial Activation Drives Activation Patterns During Long-Duration Ventricular Fibrillation and Defibrillation. Full Text available with Trip Pro

Endocardial Activation Drives Activation Patterns During Long-Duration Ventricular Fibrillation and Defibrillation. Understanding the mechanisms that drive ventricular fibrillation is essential for developing improved defibrillation techniques to terminate ventricular fibrillation (VF). Distinct organization patterns of chaotic, regular, and synchronized activity were previously demonstrated in VF that persisted over 1 to 2 minutes (long-duration VF [LDVF]). We hypothesized that activity (...) on the endocardium may be driving these activation patterns in LDVF and that unsuccessful defibrillation shocks may alter activation patterns.The study was performed using a 64-electrode basket catheter on the left ventricle endocardium and 54 6-electrode plunge needles inserted into the left ventricles of 6 dogs. VF was induced electrically, and after short-duration VF (10 seconds) and LDVF (7 minutes), shocks of increasing strengths were delivered every 10 seconds until VF was terminated. Endocardial

2017 Circulation. Arrhythmia and electrophysiology

10. Internal Cardiac Defibrillator

fibrillation by applying low-level synchronized electrical countershocks (cardioversion). Some of these stimulators have memory modules for storage and retrieval of the cardiac electrical activity and programmable capabilities. Definition (NCI_CDISC) A battery-powered electrical impulse generator implanted in patients at risk of sudden cardiac death to detect cardiac arrhythmia and correct it by delivering a jolt of electricity. Definition (NCI_NCI-GLOSS) A small device used to correct a heartbeat (...) . They consist of an impulse generator, batteries, and electrodes. Definition (CSP) implantable devices which continuously monitor the electrical activity of the heart and automatically detect and terminate ventricular tachycardia and ventricular fibrillation; consists of an impulse generator, batteries, and electrodes. Concepts Medical Device ( T074 ) MSH SnomedCT 72506001 English Cardioverter-Defibrillators, Implantable , Implantable Cardioverter-Defibrillators , Implantable Defibrillators , Defibrillators

2018 FP Notebook

11. Defibrillation Equipment

(called synchronized defibrillation or CARDIOVERSION), using relatively low-level discharges synchronized to the patient's ECG waveform. (UMDNS, 2003) Concepts Medical Device ( T074 ) MSH SnomedCT 19257004 English FIBRILLATOR, AC , Cardioverters , Defibrillator, device , defibrillators , cardioverter , defibrillator , Cardioverter , Defibrillator, device (physical object) , Defibrillator , Cardioverter, NOS , Defibrillator, NOS , Defibrillators , Stimulators, Electrical, Cardiac, Shock , Electric (...) Database) Ontology: Defibrillators (C0180307) Definition (UMD) Cardiac electrical stimulators that apply brief high-voltage electroshocks to the heart. These stimulators are used to restore normal rhythm and contractile function in patients who are experiencing ventricular fibrillation or ventricular tachycardia that is not accompanied by a palpable pulse. Some defibrillators may also be used to correct certain noncritical dysrhythmias (called synchronized defibrillation or cardioversion), using

2018 FP Notebook

12. Implantable Cardioverter-Defibrillators (Diagnosis)

) Treatment of patient discomfort Provision of psychological support: Up to 35% of people develop anxiety disorder following ICD placement, although disabling problems necessitating admission are fairly uncommon [ ] Next: Overview An implantable cardioverter-defibrillator (ICD) is a specialized implantable electronic device designed to directly treat a cardiac tachyarrhythmia, whereas a permanent is an that provides electrical stimuli, thereby causing cardiac contraction when intrinsic myocardial (...) or adjunctive therapy. See The Heart Rhythm Society's . [ ] Previous Next: ICD Complications and Malfunctions Several complications of implantable cardioverter-defibrillators (ICD) implant have been described, some of which are currently tracked in a national database of ICD implants. Acute surgical complications include the following: Pain Bleeding Pneumothorax Hemothorax Cardiac perforation with or without pericardial effusion and tamponade (sometimes requiring urgent drainage) Pulseless electrical

2014 eMedicine.com

13. Implantable Cardioverter-Defibrillators (Treatment)

) Treatment of patient discomfort Provision of psychological support: Up to 35% of people develop anxiety disorder following ICD placement, although disabling problems necessitating admission are fairly uncommon [ ] Next: Overview An implantable cardioverter-defibrillator (ICD) is a specialized implantable electronic device designed to directly treat a cardiac tachyarrhythmia, whereas a permanent is an that provides electrical stimuli, thereby causing cardiac contraction when intrinsic myocardial (...) or adjunctive therapy. See The Heart Rhythm Society's . [ ] Previous Next: ICD Complications and Malfunctions Several complications of implantable cardioverter-defibrillators (ICD) implant have been described, some of which are currently tracked in a national database of ICD implants. Acute surgical complications include the following: Pain Bleeding Pneumothorax Hemothorax Cardiac perforation with or without pericardial effusion and tamponade (sometimes requiring urgent drainage) Pulseless electrical

2014 eMedicine.com

14. Implantable Cardioverter-Defibrillators (Overview)

) Treatment of patient discomfort Provision of psychological support: Up to 35% of people develop anxiety disorder following ICD placement, although disabling problems necessitating admission are fairly uncommon [ ] Next: Overview An implantable cardioverter-defibrillator (ICD) is a specialized implantable electronic device designed to directly treat a cardiac tachyarrhythmia, whereas a permanent is an that provides electrical stimuli, thereby causing cardiac contraction when intrinsic myocardial (...) or adjunctive therapy. See The Heart Rhythm Society's . [ ] Previous Next: ICD Complications and Malfunctions Several complications of implantable cardioverter-defibrillators (ICD) implant have been described, some of which are currently tracked in a national database of ICD implants. Acute surgical complications include the following: Pain Bleeding Pneumothorax Hemothorax Cardiac perforation with or without pericardial effusion and tamponade (sometimes requiring urgent drainage) Pulseless electrical

2014 eMedicine.com

15. Implantable Cardioverter-Defibrillators (Follow-up)

) Treatment of patient discomfort Provision of psychological support: Up to 35% of people develop anxiety disorder following ICD placement, although disabling problems necessitating admission are fairly uncommon [ ] Next: Overview An implantable cardioverter-defibrillator (ICD) is a specialized implantable electronic device designed to directly treat a cardiac tachyarrhythmia, whereas a permanent is an that provides electrical stimuli, thereby causing cardiac contraction when intrinsic myocardial (...) or adjunctive therapy. See The Heart Rhythm Society's . [ ] Previous Next: ICD Complications and Malfunctions Several complications of implantable cardioverter-defibrillators (ICD) implant have been described, some of which are currently tracked in a national database of ICD implants. Acute surgical complications include the following: Pain Bleeding Pneumothorax Hemothorax Cardiac perforation with or without pericardial effusion and tamponade (sometimes requiring urgent drainage) Pulseless electrical

2014 eMedicine.com

16. 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

17. Synchronized defibrillation for ventricular fibrillation. Full Text available with Trip Pro

Synchronized defibrillation for ventricular fibrillation. Optimization of defibrillation success is important to improve efficacy and minimize post-shock sequelae. Previous work has suggested an improvement in shock success when an intracardiac shock is delivered synchronized to the upslope of a VF wave. We investigated the efficacy of transthoracic defibrillation success using a novel external biphasic defibrillator which delivers shocks synchronized to the upslope of the surface ECG.A (...) prospective, controlled, randomized study in a research institute laboratory of male and female pigs (54.2±1.8 kg). Ventricular fibrillation (VF) was induced in 10 anaesthetized and ventilated pigs. Shocks were delivered randomly from a biphasic defibrillator in synchronized or non-synchronized mode via self-adhesive electrode pads following 30 s of VF. Energy settings at 50, 70, 80, and 100J were randomly tested. VF amplitude, impedance, and shock outcome were recorded and analysed digitally.A total

2013 European heart journal. Acute cardiovascular care Controlled trial quality: uncertain

18. Sedative and Analgesic Effects of Entonox Gas Compared with Midazolam and Fentanyl in Synchronized Cardioversion. Full Text available with Trip Pro

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 Controlled trial quality: uncertain

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

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

20. Human Factors Approach to Comparative Usability of Hospital Manual Defibrillators. (Abstract)

health care providers from 5 different hospitals participated in this study. All subjects' performances were evaluated without any training on the devices being studied to assess the intuitiveness of the user interface to perform the functions of delivering an Automated External Defibrillator (AED) shock, a manual defibrillation, pacing to achieve 100% capture, and synchronized cardioversion on a rhythm simulator.Times to deliver an AED shock were fastest with the Zoll, whereas the Philips had (...) the fastest times to deliver a manual defibrillation. Subjects took the least time to attain 100% capture for pacing with the Physio-Control device. No differences in performance times were seen with synchronized cardioversion among the devices. Human factors issues uncovered during this study included a preference for knobs over soft keys and a desire for clarity in control panel design. This study demonstrated no clearly superior defibrillator, as each of the models exhibited strengths in different

2016 Resuscitation

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