Direct Current Countershock Complications

Abstract

Conversion with direct current countershock was attempted in 215 patients with arrhythmias, the majority of whom (81.9%) had atrial fibrillation. There was a fairly high frequency of complicating ventricular arrhythmias (2.5%), probably due to medication with digitalis and/or quinidine. Thromboembolism was only noted in one case, and pulmonary edema in three cases.

Direct Current Conversion of Atrial Fibrillation—long‐term Results

“…The technique, used for this material, has been previously reported (1,7). All conversions were performed on hospitalized patients.…”

2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

“…690 More dangerous arrhythmias, such as ventricular tachycardia and fibrillation, may arise in the face of hypokalemia, digitalis intoxication, or improper synchronization. 691,692 Serum potassium levels should be in the normal range for safe, effective cardioversion. Magnesium supplementation does not enhance cardio-version.…”

2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

“…Various benign arrhythmias, especially ventricular and supraventricular premature beats, bradycardia, and short periods of sinus arrest, may arise after cardioversion and commonly subside spontaneously (690). More dangerous arrhythmias, such as ventricular tachycardia and fibrillation, may arise in the face of hypokalemia, digitalis intoxication, or improper synchronization (691,692). Serum potassium levels should be in the normal range for safe, effective cardioversion.…”