[Electroshock (cardioversion) treatment problems in rhythm disorders].

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Context:

• Electroshock treatment (EST) is a critical intervention for managing cardiac rhythm disorders.
• Optimizing EST protocols requires understanding patient preparation, energy delivery, and specific arrhythmia characteristics.
• This study analyzes outcomes from a large cohort of patients undergoing EST for diverse rhythm disturbances.

Purpose:

• To evaluate the efficacy of electroshock treatment in restoring normal sinus rhythm across various cardiac arrhythmias.
• To determine optimal electrical energy parameters and patient preparation strategies for successful EST.
• To identify factors influencing treatment outcomes, including arrhythmia type and duration.

Summary:

• Successful sinus rhythm restoration was achieved in 90.1% of planned and 86.9% of emergency cases among 1027 patients.
• Atrial fibrillation showed the highest success rate (95.6%), while paroxysmal supraventricular tachycardia had a high rate (97.7%). Ventricular tachycardia and atrial flutter yielded 88% success.
• Optimal energy levels ranged from 200-300 W/s (median 250 W/s), with specific mean energies detailed for each arrhythmia type. Duration of disorder impacted results, though good outcomes were seen with longer durations. Anticoagulant prophylaxis and quinidine pre-treatment were employed selectively.

Impact:

• Provides evidence-based recommendations for optimizing electroshock therapy protocols in clinical practice.
• Contributes to improved patient outcomes by refining energy delivery and patient management strategies for cardiac arrhythmias.
• Highlights the importance of considering arrhythmia type, duration, and patient-specific factors for maximizing EST efficacy.