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[The risk of direct current countershock]
Insights
Direct current cardioversion (DCC) is a safe procedure for arrhythmias when guidelines are followed. While proarrhythmia is a risk, complications are preventable, making DCC a secure option for restoring sinus rhythm.
Area of Science:
- Cardiology
- Electrophysiology
Context:
- Direct current cardioversion (DCC) is widely used for supraventricular and ventricular arrhythmias.
- Patient populations undergoing DCC present diverse clinical conditions, complicating safety assessments.
- The safety of DCC, particularly concerning electrical current use, remains a subject of debate.
Purpose:
- To critically review literature data on the complications associated with direct current cardioversion.
- To evaluate the overall safety profile of DCC in clinical practice.
Summary:
- DCC demonstrates a high success rate in restoring sinus rhythm.
- Proarrhythmic effects of antiarrhythmic drugs can be revealed or enhanced by DCC.
- Deaths linked to DCC are primarily attributed to proarrhythmia, with fewer cases due to disease progression.
- Embolic, arrhythmic, and anesthetic complications can be mitigated by adhering to established DCC protocols.
Impact:
- Adherence to recommended procedures significantly reduces the risk of DCC-related complications.
- The findings support the conclusion that DCC is a safe intervention when performed correctly.
- Understanding and managing potential complications enhances patient safety during arrhythmia treatment.
Abstract:
Direct current cardioversion (DCC) is a procedure commonly used to restore the sinus rhythm in patients with supraventricular and ventricular arrhythmias. Its safety, regarding the use of electric current, is still a matter of controversy and debate. The patients with atrial fibrillation/flutter, supraventricular or ventricular tachycardia represent a broad spectrum of clinical conditions and it is difficult to draw the conclusions. The high success rate of DCC in restoring the sinus rhythm, may be partly responsible for enhancing and revealing proarrhythmic properties of antiarrhythmic drugs. The deaths described as a complications of DCC were mainly due to the proarrhythmia and less common to the progression of the pathologic process. The embolic, arrhythmic and anesthetic complications of DCC can be prevented if the known recommendations of performing the DCC are followed. The authors review critically the literature data about the complications of the procedure and come to the conclusion of safety of DCC.