kardioversion

Kardioversion, also known as cardioversion in English, is a medical procedure used to restore a normal heart rhythm in people with certain abnormal heart rhythms (arrhythmias). It is most commonly employed for atrial fibrillation and atrial flutter and is used in some cases of symptomatic or unstable ventricular tachycardia when other measures are inadequate.

There are two main forms of kardioversion: electrical cardioversion and pharmacologic (drug) cardioversion. Electrical cardioversion delivers a synchronized electric shock to the heart, typically via pads or paddles placed on the chest, with the aim of resetting the heart’s electrical activity to a normal rhythm. Pharmacologic cardioversion uses antiarrhythmic medications, such as amiodarone, flecainide, propafenone, or ibutilide, to achieve rhythm restoration without a shock.

Preparation and safety considerations are important. For atrial fibrillation or flutter lasting more than 48 hours or with unknown duration, anticoagulation is generally recommended for several weeks before cardioversion, or a transesophageal echocardiogram may be performed to exclude a left atrial thrombus. Electrical cardioversion is performed under sedation or anesthesia with continuous monitoring. Potential risks include thromboembolism, skin burns, arrhythmias, or rare complications such as heart block or ventricular fibrillation. Pharmacologic cardioversion carries risks of drug-specific adverse effects and proarrhythmia, especially in patients with structural heart disease.

Outcomes and follow-up vary. Electrical cardioversion often converts to sinus rhythm quickly, but recurrence of atrial fibrillation/flutter is common, necessitating ongoing management with medications, lifestyle modification, or ablation. Long-term decisions depend on symptoms, rhythm history, and stroke prevention considerations.