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Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
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The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
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Related Experiment Video

Updated: Dec 26, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Early versus delayed cardioversion: why should we wait?

K E Juhani Airaksinen1

  • 1Heart Center, Turku University Hospital, University of Turku, Turku, Finland.

Expert Review of Cardiovascular Therapy
|March 14, 2020
PubMed
Summary
This summary is machine-generated.

Timing cardioversion (CV) for atrial fibrillation (AF) impacts success. Early CV (12-48 hours) improves outcomes and reduces recurrence, but effective anticoagulation is crucial to prevent complications.

Keywords:
Antiarrhythmic drugsanticoagulationatrial Fibrillationcardioversionstrokethromboembolic complication

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Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Cardioversion (CV) is key for atrial fibrillation (AF) rhythm control.
  • The timing of CV significantly influences treatment efficacy and safety.

Purpose of the Study:

  • To review how the timing of CV affects the success and safety of rhythm control for AF.
  • To identify optimal timing for CV based on current evidence.

Main Methods:

  • Review of observational studies on CV timing in AF.
  • Analysis of data regarding CV success rates, recurrence, and complications based on timing.

Main Results:

  • CV success is higher for acute (<48 hours) AF compared to persistent AF.
  • Early CV timing appears to reduce AF recurrences.
  • Delayed CV increases thromboembolic risk despite anticoagulation.
  • Arrhythmic complications post-CV are rare regardless of timing.

Conclusions:

  • Optimal CV timing is likely 12-48 hours after symptom onset.
  • Evaluate treatment failure probability and antiarrhythmic options before CV.
  • Effective anticoagulation is critical, especially during the first week post-CV.