A commonly performed off site procedure requiring anesthesia is an elective cardioversion. Cardioversion is often a brief, yet painful procedure which utilizes an electrical current applied transcutaneously to the patient’s chest for the treatment of cardiac dysrhythmias. The anesthetic management of cardioversion can vary widely based on the setting, patient, and provider. General anesthesia, with or without airway control, is often indicated. There are several unique anesthetic considerations to be taken into account for preoperative assessment, optimization of current medical conditions, and preparation of an anesthetic plan for an elective cardioversion. Additionally, knowledge of the procedure and the underlying physiology and pathology of cardiac dysrhythmias assists the anesthesiologist in preparing for management of adverse events.
KeywordsSynchronized cardioversion Atrial fibrillation Arrythmias Off-site anesthetic
- 1.American College of Cardiology/American Heart Association Task Force on Practice Guidelines; European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for Management of Patients With Atrial Fibrillation); European Heart Rhythm Association; Heart Rhythm Society. Circulation. 2006;114:e257–354.Google Scholar
- 6.Atkins DL, Passman RS, Halperin HR, Samson RA, White RD, et al. Part 6: electrical therapies: automated external defibrillators, defibrillation, cardioversion, and pacing: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 Suppl 3):S706–19.PubMedPubMedCentralGoogle Scholar
- 10.Statement on Nonoperating Room Anesthetizing Locations Committee of Origin: standards and practice parameters (Approved by the ASA House of Delegates on October 19, 1994, and last amended on October 16, 2013).Google Scholar
- 16.Lewis SR, Nicholson A, Reed SS, Kenth JJ, Alderson P, Smith AF. Anaesthetic and sedative agents used for electrical cardioversion. Cochrane Database Syst Rev. 2015;(3):CD010824.Google Scholar