Abstract
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.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
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.
Lesser MF. Safety and efficacy of in-office cardioversion for treatment of supraventricular arrhythmias. Am J Cardiol. 1990;66:1267–8.
Ewy GA. The optimal technique for electrical cardioversion of atrial fibrillation. Clin Cardiol. 1994;17:79–84.
Page RL, Kerber RE, Russell JK, et al. Biphasic versus monophasic shock waveform for conversion of atrial fibrillation: the results of an international randomized, double-blind multicenter trial. J Am Coll Cardiol. 2002;39:1956–63.
Mittal S, Ayati S, Stein KM, et al. Transthoracic cardioversion of atrial fibrillation: comparison of rectilinear biphasic versus damped sine wave monophasic shocks. Circulation. 2000;101:1282–7.
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.
Dahl CF, Ewy GA, Warner ED, et al. Myocardial necrosis from direct current countershock. Effect of paddle electrode size and time interval between discharges. Circulation. 1974;50:956–61.
Gould L, Patel S, Gomes GI, Chokshi AB. Pacemaker failure following external defibrillation. Pacing Clin Electrophysiol. 1981;4(5):575–7.
Schroeder JS, Harrison DC. Repeated cardioversion during pregnancy. Am J Cardiol. 1971;27:445–6.
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).
Canessa R. Anesthesia for elective cardioversion: a comparison of four anesthetic agents. J Cardiothorac Vasc Anesth. 1991;5(6):566–8.
Desai PM, Kane D, Sarkar MS. Cardioversion: what to choose? Etomidate or propofol. Ann Card Anaesth. 2015;18(3):306–11.
Kalogridaki M. Anaesthesia for cardioversion: a prospective randomised comparison of propofol and etomidate combined with fentanyl. Hellenic J Cardiol. 2011;52(6):483–8.
Rabbino MD, Likoff W, Dreifus LS. Complications and limitations of direct current countershock. JAMA. 1964;190:417–20.
Ferson D, Thakar D, Swafford J, Sinha A, Sapire K, Arens J. Use of deep intravenous sedation with propofol and the laryngeal mask airway during transesophageal echocardiography. J Cardiovasc Vasc Anesth. 2003;17:443–6.
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.
Mancini GB, Goldberger AL. Cardioversion of atrial fibrillation: consideration of embolization, anticoagulation, prophylactic pacemaker, and long-term success. Am Heart J. 1982;104:617–21.
Kern KB, Hilwig RW, Rhee KH, Berg RA. Myocardial dysfunction after resuscitation from cardiac arrest: an example of global myocardial stunning. J Am Coll Cardiol. 1996;28(1):232–40.
Bjerkelund CJ, Orning OM. The efficacy of anticoagulant therapy in preventing embolism related to D.C. electrical conversion of atrial fibrillation. Am J Cardiol. 1969;23:208–16.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Sumler, M.L., Hollon, M. (2018). Anesthesia for Cardioversion. In: Goudra, B., et al. Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-74766-8_22
Download citation
DOI: https://doi.org/10.1007/978-3-319-74766-8_22
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-74765-1
Online ISBN: 978-3-319-74766-8
eBook Packages: MedicineMedicine (R0)