The term "electrical cardioversion" means a method of restoring normal heart rate when heart rhythm disorders, like atrial fibrillation. The goal is to get back to the heart in so-called sinus rhythm the normal regular heartbeat. Atrial fibrillation is a functional disorder in which the spread of excitation proceeds uncoordinated. On the basis of sinus rhythm is regulated by the rhythmic movement of the heart. Using electrical cardioversion attempts to restore the orderly activity of the sinus node, the electric generator of synchronizing impulses of heart activity, so that the heart again beats in right rhythm.
What you need to pay attention before carrying out electrical cardioversion in patients with atrial fibrillation?
In the case of a diagnosis of atrial fibrillation, the therapeutic goal may be control of heart rate. Electrical cardioversion is a non - invasive intervention, that is, without surgery is to normalize heart rhythm.
As the electrical cardioversion in atrial fibrillation associated with increased risk of embolism, before each intervention it is necessary to find out in the event each individual patient whether he personally this method of treatment.
In patients with atrial fibrillation due to irregular blood circulation in the atrium of the heart can form blood clots, called thrombi. Breaking away and falling with the flow of blood to the brain, these clots can clog an artery and thereby lead to stroke. Reasons for withdrawing thrombus from the atrium by the flow of blood may be different. For example, a cause may be a current pulse that is given and during electrical cardioversion. Therefore, before the electrical cardioversion, it is important to exclude the presence of thrombus in the atrium. To clarify the situation transesophageal echocardiography (Tee). In this case we are talking about ultrasound, during which the esophagus is particularly clearly visualized certain areas of the heart, which allows us to determine the presence of blood clots. This preliminary study for the most part is painless for the patient, as it is performed under local anesthesia of the throat with anesthetic spray.
How is electrical cardioversion?
For patients in whom atrial fibrillation occurs more than 48 hours or unknown duration, the European society of cardiology recommends before the procedure, electrical cardioversion oral anticoagulant therapy for at least three weeks. After the intervention anticoagulant therapy continues for four weeks.
Typically, electrical cardioversion is performed in the outpatient setting. In order to eliminate the possibility of swallowing the remnants of food or something similar during the intervention, it is necessary that the patient came to the clinic or medical practice at the scheduled time on an empty stomach. Also, for the study patients must bring the following documents:
Electrical cardioversion is performed under short General anesthesia and therefore for the patient the procedure is painless. In the course of the treatment is constant monitoring of the ECG of the patient. With the help of current pulses (dose which is significantly lower than, for example, when defibrillation) the heart rhythm returns to sinus rhythm. The pulse generator pushes current in this case is your own heartbeat, which is detected during the ECG. Thus, it is possible to reduce the risk of ventricular fibrillation of the heart.
After a successful electrical cardioversion the patient has enough time to move away from short-term anesthesia. Although narcotic effects are minor, the patient on this day you can no longer work or drive a car.
During the closing conversation, the doctor sets the date for holding the first control examination, in which with the help of ECG is checked whether proper heart rhythm. Regardless of whether after electrical cardioversion sinus rhythm, patients with existing risk factor for stroke or intermittent atrial fibrillation shown holding oral anticoagulant therapy throughout life.