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Defibrillation threshold indicates the minimum amount of energy needed to return normal rhythm to a heart that is beating in a cardiac dysrhythmia. Typical examples are the minimum amount of energy, expressed in joules , delivered by external defibrillator paddles or pads, required to break atrial fibrillation and restore normal sinus rhythm .
Drugs like amiodarone, diltiazem, verapamil and metoprolol are frequently given before electrical cardioversion to decrease the heart rate, stabilize the patient and increase the chance that cardioversion is successful. There are various classes of agents that are most effective for pharmacological cardioversion.
It works partly by increasing the time before a heart cell can contract again. [4] [6] Amiodarone was first made in 1961 and came into medical use in 1962 for chest pain believed to be related to the heart. [8] It was pulled from the market in 1967 due to side effects. [9] In 1974 it was found to be useful for arrhythmias and reintroduced. [9]
However, neither lidocaine nor amiodarone, in those who continue in ventricular tachycardia or ventricular fibrillation despite defibrillation, improves survival to hospital discharge, despite both equally improving survival to hospital admission. [112] Following an additional round of CPR and defibrillation, amiodarone can also be administered.
Compounds that prolong the action potential: matching the modern classification, with the key drug example being amiodarone, and a surgical example being thyroidectomy. This was not a defining characteristic in an earlier review by Charlier et al. (1968), [ 17 ] but was supported by experimental data presented by Vaughan Williams (1970).
Amiodarone is also safe to use in individuals with cardiomyopathy and atrial fibrillation, to maintain normal sinus rhythm. Amiodarone prolongation of the action potential is uniform over a wide range of heart rates, so this drug does not have reverse use-dependent action. Amiodarone was the first agent described in this class. [4]
Defibrillation is often an important step in cardiopulmonary resuscitation (CPR). [6] [7] CPR is an algorithm-based intervention aimed to restore cardiac and pulmonary function. [6] Defibrillation is indicated only in certain types of cardiac dysrhythmias, specifically ventricular fibrillation (VF) and pulseless ventricular tachycardia.
Longer time-to-ROSC is associated with a worse presentation of PCAS. [9] Lazarus phenomenon is the rare spontaneous return of circulation after cardiopulmonary resuscitation attempts have stopped in someone with cardiac arrest. This phenomenon most frequently occurs within 10 minutes of cessation of resuscitation, thus passive monitoring is ...