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Synchronic Electric Cardioversion
in the Intensive Care Unit
Escobar, Hugo; Colunga, Justo;
León, Rafael; Calderón, Javier
Provincial Clinical Surgical Hospital
"Manuel Ascunce Domenech",
Introduction: Synchronic electric cardioversion consist in the application of one discharge of continuous current in the thorax so as to interrupt a cardiac arrhythmia. After more than three decades, it still presents controversial aspects.
Objective: Evaluate the effectiveness of electric cardioversion for interrupting cardiac arrhythmias.
Methods: Analytical, prospective, cross-sectional study in 100 patients with cardiac arrhythmias subjected to electric synchronic urgent or elective cardioversion who were admitted in the Intensive Care Unit from January 1997 to July 2000. Those with digital intoxication, electrolytic disorders, severe respiratory failure, presence of intracavity thrombus and left atrial greater than 45 mm were excluded from the study. Elective patients were performed electrocardiogram, ionogram and transthoracic echocardiogram. Carriers of rheumatic cardiopathy received 5000 units of Sodic Heparin endovenous, those with digital 50 mg of Lidocaine previous to the procedure. As anaesthetic, we used 50mg of Ketamine and/or 5mg of Diazepam. We used 70J as initial energy for atrial flutter and supraventricular paroxistic tachycardia and 100J for atrial fibrillation and ventricular tachycardia with progressive increments of energy and a time of 3 minutes among discharge.
Result: A 70% were men and 68% older than 50 years. The suffered of ischemic cardiopaty to 60%. Ventricular tachycardia (43%) was the arrhythmia with greater cardioversion, followed by atrial fibrillation (30%) and atrial flutter 2:1 (18%). Urgent cardioversion was performed in 76% and elective in 24%. The procedure was successful reverting to sinusal rhythm a 93%; 70% received a discharge, two 18% and three or more 12%. Complications didn't occur with this procedure.
Conclusions: Synchronic electric cardioversion resulted in an effective therapeutic and safe method for the treatment of cardiac arrhythmias.
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2nd Virtual Congress of Cardiology
Dr. Florencio Garófalo
Dr. Raúl Bretal
Dr. Armando Pacher
Technical Committee - CETIFAC
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