Open AccessThe optimal technique for electrical cardioversion of atrial fibrillation
Author(s) -
Ewy Gordon A.
Publication year - 1994
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960170207
Subject(s) - medicine , atrial fibrillation , cardioversion , paddle , electrical cardioversion , cardiology , electrode , shock (circulatory) , anesthesia , biomedical engineering , composite material , chemistry , materials science
The optimal approach to electrical cardioversion of atrial fibrillation includes appropriate patient selection, anticoagulation, careful selection and monitoring of antiarrhythmic therapy, and proper electrical cardioversion technique. The optimal technique requires the use of metal electrodes, with one electrode of at least 8 cm in diameter placed in the anterior position, and the second of 12–13 cm diameter placed posteriorly just below the left scapulae, with generous amounts of the appropriate gel (such as Hewlett‐Packard Redux Paste) as the electrode‐skin interface and firm pressure to the paddle electrode with the patient in expiration. Thus the anterior‐posterior chest diameter is decreased and less air between the electrodes is assured. The initial shock strength should be 200 J. The shock is synchronized with the electrocardiographic QRS complex. This report reviews the justification for these recommendations.