Cardioversion and its Types

Cardioversion is a medical procedure that is utilised for quick, low-energy shocks that are restoring rhythm. The procedure will be used in conditions like arrhythmias and atrial fibrillation. It is also done in integration with medication. Two main types of cardioversion are electro-version and chemical (pharmacological). Electro version where a machine and sensor are used to deliver low-energy shocks to the chest regions (Pogson, 2021). It allows healthcare professionals to restore typical heartbeats. Second is pharmacology, which is using medication for restoring the rhythm of the heart. It would not require the administration of medication.

Case Study

Mr John is a 56-year-old patient. He is admitted to the intensive treatment units for the treatment of atrial fibrillation. It is defined as a condition that leads to an irregular, often rapid heartbeat that is due to poor flow of blood in the regions of the heart. The usual signs and symptoms will be reported, a heartbeat of more than 140 beats per minute and an irregular heartbeat. The medical history of patients involves hypertension and excess weight. He is taking medication for hypertension and his weight is reported to be more than 80 kg. Healthcare professionals recommend Cardioversion to overcome the AF condition.

Arrhythmia

Atrial fibrillation (A-fib) is a type of arrhythmia that affects the left atrium. There is an unorganised heart rhythm in the upper chambers of the heart. The main causative behind AF is the issue with the sinus node. It is sending signals to the upper two chambers and lower two chambers that is keeping the heartbeat on track (Brandes et al. 2020). It makes the chambers struggle to work together. Risk factors behind the condition are heart disease, high blood pressure and chronic health conditions like weight and other conditions.

Procedure of Cardioversion

It is seen that the intravenous line in the arm is inserted. Then medication is administered through the IV lines during the procedure. Followed by electrocardiogram patches and adhesive cardioversion pads will get adhesive on the chest (Hartikainen, 2020). After that, a thin tube is inserted with a transducer that checks the blood clots and creates a pictorial of the heart. The delivery of a specific amount of energy in the heart will make the heart rhythm to be restored. The technique will make the heart rhythm and other vitals to be managed for an individual.

Risk and Complication of Cardioversion in the Patient

The complications are temporary that are associated with cardioversion which is rash or temporary damage to the skin due to the insertion of electrodes. Second is bruised skin to the intravenous due to long time insertion of the cannula. Blood clots in the heart will lose and cause a stroke due to the sudden delivery of the shock (Nguyen et al. 2023). Heart rhythm gets worsen due to comorbidity that leads to the abnormal rhythm and makes the beat get triggered. Lastly, an allergic reaction to a medication is seen in the second type of cardioversion.

Nursing Care for Cardioversion

Following the nursing care for cardioversion that is as follows by which the care and standard care will be provided to the patient.

  1. Ensure the patient is on anticoagulation medication for 4-6 weeks before the procedure that causes blood clots. It helps in preventing blood clots that are causing cardioversion.
  2. Standing clear while delivering a shock makes sure that the shock is delivered in the right way and oxygen is cleared as well.
  3. Monitoring the patient after the procedure of cardioversion is maintaining the airway and paying particular attention to dislodged clots. It causes serious complications such as stroke, myocardial infarction and pulmonary embolism (Ahmed et al., 2019).
  4. Monitoring vital signs is important for the better delivery of interventions that leads to an idea of what is the rate of shock and what is the response of the patient.
  5. Treating underlying causes that are made up of to stop bleeding and prevent the causes that are expected during the interventions (Mokhtari et al., 2022).
  6. Maintaining the position of the patient that makes the assistance during the time of fluid redistribution that is modified with the Trendelenburg position that is overcoming the hypovolemic shock.

With the sake of nursing care, the complication and risk factors for the patient is reduced. It allows the management of vital signs and leads to safe care. In conclusion, cardioversion is restoring sinus rhythm and the reported success rate will be in the range of 50 to 90 per cent.

References

Ahmed, S. M., Muhammad, Z. A. E. L., Ali, H. H., Muhammad, M. A., & Mehany, M. M. (2019). Effect of an educational program on nurses' knowledge and practice regarding defibrillation and cardioversion. Assiut Scientific Nursing Journal, 7(17), 24-31.https://dx.doi.org/10.21608/asnj.2019.56786

Brandes, A., Crijns, H. J., Rienstra, M., Kirchhof, P., Grove, E. L., Pedersen, K. B., & Van Gelder, I. C. (2020). Cardioversion of atrial fibrillation and atrial flutter revisited: current evidence and practical guidance for a common procedure. EP Europace, 22(8), 1149-1161.https://doi.org/10.1093/europace/euaa057

Hartikainen, J. E. (2020). Cardioversion. In Sex and Cardiac Electrophysiology (pp. 493-500). Academic Press.https://doi.org/10.1016/B978-0-12-817728-0.00043-7

Mokhtari, M., Esfahani, A. K., & Mohamadirizi, S. (2022). The Effect of the Clinical Supervision Model on Nurses’ Performance in Atrial Fibrillation Care. Iranian Journal of Nursing and Midwifery Research, 27(3), 216-220.http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/1892

Nguyen, S. T., Belley-Côté, E. P., Ibrahim, O., Um, K. J., Lengyel, A., Adli, T., ... & McIntyre, W. F. (2023). Techniques improving electrical cardioversion success for patients with atrial fibrillation: a systematic review and meta-analysis. Europace, 25(2), 318-330.https://doi.org/10.1093/europace/euac199

Pogson, D. (2021). Cardioversion. In Key Topics In Anaesthesia (pp. 70-71). Routledge.https://www.taylorfrancis.com/chapters/edit/10.1201/9780203749685-25/cardioversion-dave-pogson

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