Cardioverter

Cardioverter is a term used in cardiology for devices and procedures that restore a normal heart rhythm by electrical therapy. It is most commonly associated with cardioverter-defibrillators, devices that monitor heart rhythm and deliver shocks or paced therapy to terminate dangerous arrhythmias or to reset rhythm after a tachyarrhythmia. The term encompasses external cardioversion, defibrillation, and implanted or wearable devices that perform these functions.

External cardioversion uses synchronized electrical shocks delivered to the heart through pads on the chest, usually in a hospital. It is used to restore rhythm in stable, symptomatic atrial fibrillation or atrial flutter, and other supraventricular tachycardias when rapid relief is desired. Defibrillation is unsynchronized and is used for life-threatening ventricular fibrillation or pulseless ventricular tachycardia.

Implanted cardioverter-defibrillators (ICDs) monitor heart rhythm continuously and can deliver shocks or pacing therapies as needed. Wearable cardioverter-defibrillators (WCDs) are external vest-like devices worn by at-risk patients until a long-term solution is chosen. Indications include secondary prevention after survived cardiac arrest and primary prevention in patients with high risk due to cardiomyopathy, ischemic heart disease, or other conditions. Risks include skin burns, infection for implanted devices, inappropriate shocks, and device-related complications; follow-up and battery replacement are required for implanted systems.