[Electroshock (cardioversion) treatment problems in rhythm disorders]

Some problems associated with the results from the electroshock treatment of 1027 patients with rhythm disorders are discussed, as well as the choice of the necessary quantity of electric energy and the way of preparation of the patients. It was established, that sinus rhythm restoration was attained in 90.1% under planned conditions, and in emergency cases--in 86.9%. The highest percentage of positive results were obtained with atrial fibrillation (95.6), and the lowest--with paroxysmal supraventricular tachycardia (97.7). The results is identical (88%) with ventricular tachycardia and atrial flutter. The duration of the rhythm disorder is of importance for the result, being the best up to the third month after the origination of the disorder, but good results had been obtained with a longer duration. The quantity of energy from 200 to 300 W/s (median 250 W/s) was outlined as optimal. The mean quantity of electric energy used in atrial flutter was 278.8 +/- 51.7, in paroxysmal supraventricular tachycardia--246.3 +/- 57.8 in atrial fibrillation--229.5 +/- 40.7 and in ventricular tachycardia--182.9 +/- 37.5 W/s. The anticoagulant prophylaxis is carried out in the patients with a longer duration of the rhythm disorder, in the patients with heart defects and those with ischemic heart disease (with eventual aneurysm). There was a single pre-treatment with quinidine--0.20 or 0.40.