Which rhythm requires synchronized cardioversion?

As a medical professional with expertise in cardiology, I can provide you with an informed answer regarding synchronized cardioversion. Synchronized cardioversion is a procedure that is used to correct certain types of abnormal heart rhythms by delivering an electric shock to the heart. The term "synchronized" refers to the timing of the shock, which is coordinated with the patient's natural heartbeat to ensure it is delivered during the relative refractory period of the cardiac cycle. This is important because delivering the shock at the right time can minimize the risk of inducing ventricular fibrillation, a life-threatening condition. The primary rhythm that requires synchronized cardioversion is atrial fibrillation (AFib). AFib is a common type of irregular and often rapid heart rate that can lead to various complications if not managed properly. Synchronized cardioversion is particularly useful for converting AFib back to a normal sinus rhythm, especially when the onset of the condition is recent. Another rhythm that may require synchronized cardioversion is atrial flutter (AFL), which is similar to AFib but with a more regular pattern. Like AFib, AFL can also be converted to a normal rhythm using synchronized cardioversion. It is important to note that synchronized cardioversion is not used for rhythms like ventricular fibrillation or pulseless ventricular tachycardia, as these conditions require immediate defibrillation without synchronization, a procedure known as unsynchronized cardioversion. In summary, the main rhythm that requires synchronized cardioversion is atrial fibrillation, with atrial flutter being another possible candidate.

Synchronized electrical cardioversion is used to treat hemodynamically unstable supraventricular (or narrow complex) tachycardias, including atrial fibrillation and atrial flutter. It is also used in the emergent treatment of wide complex tachycardias, including ventricular tachycardia, when a pulse is present.