Cardioversion and defibrillation are treatments aimed at restoring normal heart function. Both defibrillation and cardioversion rely on a short-term effect of an electric current on the patient's heart. However, both procedures are performed for other types of arrhythmia. There are other differences between defibrillation and cardioversion.

Defibrillationandcardioversionare treatments aimed at restoring the normal operation (rhythm) of the heart. Both defibrillation and cardioversion rely on a short-term effect of an electric current on the patient's heart. However, both procedures are performed for other types of cardiac arrhythmias.

Are there other differences between defibrillation and cardioversion?

Defibrillation - indications

Defibrillation is an emergency procedure performed in life-threatening conditions requiring immediate treatment, i.e. in the case of:

  • ventricular fibrillation,
  • pulseless ventricular tachycardia.

Defibrillation is the most effective method of restoring heart rate in VF.

How does the defibrillator work?

In ventricular fibrillation, individual cells in the heart muscle contract independently of one another in an uncoordinated manner. Consequently, the entire heart ( although its individual cells are functioning) does not contract and is unable to pump blood. As a result of the defibrillator, all heart muscle cells stop simultaneously and then simultaneously start to contract synchronously, causing the entire heart to contract.

How do I deliver a shock?

Lay the patient on his back on a firm surface. Make sure that no part of the body touches water (the victim must not lie in a puddle, etc.) or metal parts (the patient must not touch the bed frame, etc.). Then the patient's chest is exposed and two electrodes are placed or glued to it (depending on the type of defibrillator).

IMPORTANT! The electrodes should adhere directly to the skin - it must not be hairy. The device then sends electrical pulses to the heart.

There are several types of defibrillators:

  • stationary - with metal "spoons" that are placed on the patient's chest and a monitor showing the type of arrhythmia. Defibrillators of this type used in hospitals and ambulances
  • automatic external (AED) - with disposable electrodes glued to the chest, and a device for assessing the rhythm of the heart. Defibrillators of this type analyze the patient's heart rhythm on their own and decide whether defibrillation is required, whether CPR should be initiated or continued. When the device detects a shockable condition, it alerts the environment and then defibrillates.Shockis performed until the heart rhythm is restored to normal. Automatic defibrillation equipmentdefibrillationis generally available in public places (airports, railway stations, museums, gas stations, shopping malls, etc.)

Externaldefibrillatorstake over the supervision of the rescue operation and give voice instructions (in Polish), therefore they should be used by any person who witnesses an accident in which immediate assistance is required .

Ariel Szczotok, paramedic, shows how to use an automatic defibrillator

Cardioversion - indications for making

Cardioversioncan be performed in life-threatening situations, and also as a planned procedure in the following cases:

  • atrial fibrillation
  • ventricular and supraventricular tachycardia

Before the procedure, an EKG of the heart is performed. The shock during cardioversion must be synchronized with the ECG trace. Why? Because duringcardioversionthe discharge occurs at the top of the R wave. Failure to synchronize energy with the heart's electrical activity may result in ventricular fibrillation, especially when the discharge occurs during the relative refraction period of cardiomyocytes (T wave on the ECG).

Patients with atrial fibrillation and flutter must be treated with anticoagulants for 4 weeks to avoid possible vessel embolism. Before the procedure, the patient must not eat for at least 6 hours.

What is the cardioversion procedure?

The patient receives short-term general anesthesia. When he falls asleep, the doctor applies electrodes to the chest and triggers an electrical impulse (sometimes consisting of several impulses) to restore the heart's normal rhythm.

Worth knowing

Cardioversion and defibrillation - difference

Cardioversiondiffers fromdefibrillationin that:

  • records the heart rhythm in the EKG trace,
  • the shock is synchronized with the electrical activity of the heart to avoid VF occurrence during the shock during the reactive refractory period,
  • to regulate the heart rate, lower energy values ​​are used than indefibrillation .

Category:

Cardiology