The Use of Cardioversion to Correct Cardiac Arrhythmia

Introduction

Have you ever felt like your heart was racing, fluttering, or skipping a beat? These sensations can be signs of cardiac arrhythmia, which is common, especially in older adults. If you experience these symptoms occasionally, they are usually harmless. However, some arrhythmias that persist longer can be critical and require management and treatment. Cardiac arrhythmia is a class of conditions where the electrical activity of the heart is abnormal. One way to correct certain arrhythmias, such as atrial fibrillation and atrial flutter, is by performing a medical procedure called “Cardioversion”. As a group, we would like to explain why it is important to distinguish when cardioversion will be used versus defibrillation.

The Use of Cardioversion to Correct Cardiac Arrhythmia

According to Heart.com, “Arrhythmias can produce a broad range of symptoms, from barely perceptible to cardiovascular collapse and death” (Heart.com, n.d.). Various diagnostic tests are used to confirm arrhythmias. We will also explain the two types of cardioversion procedures used to correct an irregular heartbeat and what occurs before, during, and after cardioversion. We will discuss nursing implications, including patient education throughout the process of a cardioversion procedure.

Understanding Arrhythmia and Cardioversion

An arrhythmia is a change in the rhythm of your heartbeat. Arrhythmias are more serious if you have other heart problems. Cardioversion is a corrective procedure to change or convert an irregular heart rhythm back to normal sinus rhythm. This procedure is usually elective; the patient is awake but sedated, and a consent form must be signed prior to the procedure. According to Heart.com, cardioversions are done to treat atrial fibrillation (AFib) or atrial flutter (AFL) and non-life-threatening irregular rhythms in the top of the heart (Heart.com, n.d.). It is also used in less urgent cases to try to convert the rhythm back to normal.

Distinguishing Cardioversion and Defibrillation

Defibrillation is used for immediately life-threatening arrhythmias when the patient does not have a pulse, such as ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). The goal for both procedures is to deliver electrical energy to the heart to shock it temporarily, allowing a normal sinus rhythm to resume via the heart's normal pacemaker. In cases where an electrical shock is needed, if the patient is stable, and you can see a QRS-t complex, you will use low-energy synchronized cardioversion. However, if the patient is pulseless, or if the patient is unstable and the defibrillator will not synchronize, you will use high-energy unsynchronized cardioversion (defibrillation).

Symptoms and Diagnostic Tests for Arrhythmia

Patients with arrhythmias can be asymptomatic. When arrhythmias last long enough to affect heart function, more serious symptoms can occur, such as syncope or near-fainting spells, chest pain, and fatigue. In severe cases, collapse and sudden cardiac arrest can emerge. Diagnostic tests used to confirm arrhythmia include chest X-rays, blood tests, stress tests, and electrocardiograms.

The Role of Electrocardiogram (ECG) in Diagnosing Arrhythmias

There are other tests or procedures used to determine arrhythmias; however, an electrocardiogram (ECG) is the most common. ECG is used to check for signs of heart disease. It's a test that records the electrical activity of your heart through small electrode patches placed on the chest, arms, and legs. The ECG diagnostic test is commonly used because it’s reliable, fast, safe, and painless.

Conclusion

Understanding the differences between cardioversion and defibrillation is crucial for effectively managing cardiac arrhythmias. Both procedures play vital roles in restoring normal heart rhythms and preventing serious complications. It is essential to use appropriate diagnostic tests, such as the ECG, to accurately diagnose and treat arrhythmias, ensuring the best possible outcomes for patients.

References

• Heart.com. (n.d.). Understanding arrhythmias. Retrieved from https://www.heart.com/arrhythmias