To regulate the cardiac arrhythmia of patients suffering from atrial fibrillation, they may be offered an electric shock or cardioversion. Why Doctor asked a specialist about this simple and quick procedure to perform.
Atrial fibrillation (or atrial fibrillation), often called AF, is the most common heart rhythm disorder in adults over 40. Its main risk is the occurrence of a cerebrovascular accident (CVA) and hemiplegia (paralysis of one or more parts of the body, on one side only). Most of the time, AF is difficult to diagnose upstream because it is asymptomatic. However, for patients in whom this is not the case and the abnormal palpitations persist, doctors may offer anti-arrhythmic drugs. If these do not work, there are alternatives such as the solution of electric shock or cardioversion. On the occasion of atrial fibrillation awareness day this Thursday, December 12, Why Doctor interviewed Doctor Xavier Waintraub, cardiologist at La Pitié-Salpêtrière hospital in Paris, about this practice.
Concretely, the latter “consists of sending a high-energy current to the level of the chest so as to be able to resynchronize all the cardiac cells to restore the normal rhythm”, he explains. The patient must arrive on an empty stomach the morning of the procedure. A nurse takes a blood sample, inserts the infusion, records an electrocardiogram and he is then put to sleep under general anesthesia.
In the operating room there is a defibrillation device, the external defibrillator and a screen to measure the patient’s arrhythmia. “Once he is asleep, we charge the device and we choose the energy to be delivered. Then, when the charge is ready, we take the paddles and deliver the electric shock by applying it to the patient’s chest. It is necessary to ensure that the palettes take the auricle in their field. By pressing like this, we deliver energy to restore a normal heart rhythm”, explains Xavier Waintraub. The procedure lasts less than five minutes, which greatly limits side effects.
Very good results
“It is an act that can be done at any time in the history of the patient’s atrial fibrillation. This can be done initially in a person who comes to consult for the first time for symptomatic atrial fibrillation or it can be a patient who, unfortunately, will suffer from fibrillation again after an ablation procedure”, explains the cardiologist.
Fortunately, “the results of the electric shock treatment are very good: we have about 90% restoration of the normal rhythm”. In detail, the patient recovers a heart rate appropriate to the effort as well as a contraction of the atrium synchronized with that of the ventricle. For some, the benefits are going to be immediate while for others, they can arrive after a week. However, the success rate may be lower in those who have had AF for more than a year or who have complications such as heart failure, consequent dilation of the heart atria or abnormal heart valves.
Ensuring that the normal heart rhythm continues
Moreover, the electric shock is only able to relieve the symptoms of AF but not to treat the causes. Also, recurrences can occur very quickly and it happens that a patient must undergo several cardioversions.
“Afterwards, the problem is above all to manage to ensure that it continues. Hence the importance of drug treatment. It is up to the doctor to find a drug that allows the sinus rhythm to be maintained”, declares Xavier Waintraub. This is why, after an electric shock, the cardiologist will refer the patient to an anti-arrhythmic treatment to avoid relapses or will suggest that he undergo radiofrequency ablation or cryotherapy, depending on the severity of his pathology and his history.
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