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Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
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Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
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Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
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Electrocardiogram Fundamentals01:28

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Waveform optimization for internal cardioversion of atrial fibrillation.

Vivek Kodoth1, Noel C Castro, Ben M Glover

  • 1The Heart Centre, Royal Victoria Hospital, Belfast, Northern Ireland.

Journal of Electrocardiology
|October 25, 2011
PubMed
Summary

Low-tilt biphasic waveform (LTBW) demonstrated superior efficacy for transvenous cardioversion of atrial fibrillation (AF) compared to low-tilt monophasic waveform (LTMW). Radiofrequency-powered defibrillation offers a safe and effective low-energy option for AF cardioversion.

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Area of Science:

  • Biomedical Engineering
  • Cardiology
  • Medical Devices

Background:

  • A novel radiofrequency-powered atrial defibrillator was developed for cardioversion.
  • The device utilizes low-tilt monophasic waveform (LTMW) and low-tilt biphasic waveform (LTBW) with a 12 ms pulse width.
  • This study aimed to compare the safety and efficacy of LTMW versus LTBW for transvenous cardioversion of atrial fibrillation (AF).

Purpose of the Study:

  • To compare the efficacy and safety of LTMW and LTBW for transvenous cardioversion of AF.
  • To evaluate the effectiveness of a novel radiofrequency-powered defibrillator.
  • To determine optimal waveform parameters for low-energy cardioversion.

Main Methods:

  • Thirty patients with AF were randomized to receive either LTBW or LTMW.
  • Patients were pre-treated with warfarin to maintain an International Normalized Ratio (INR) between 2 and 3 for 4 weeks.
  • Cardioversion was attempted in a step-up voltage progression (50-300 V), with crossover to the alternative waveform if initial attempts failed.

Main Results:

  • LTBW cardioverted 46% (7/15) of patients, while LTMW cardioverted 6% (1/15) (P = .035).
  • Including crossover, 46% (14/30) of patients were successfully cardioverted.
  • No major adverse complications were observed, and postcardioversion cardiac markers were unremarkable.

Conclusions:

  • Low-tilt biphasic waveform (LTBW) is more efficacious for low-energy transvenous cardioversion of AF.
  • Radiofrequency-powered defibrillation is a safe and effective method for transvenous cardioversion of AF.
  • A significant number of patients achieved sinus rhythm with low energy using this novel device.