Electrical defibrillation is a method of stopping ventricular fibrillation by delivering a certain amount of electrical current to the heart. It is a reasonable method for treating atrial fibrillation, and now the application of direct current defibrillation is more common. The initial defibrillator used industrial alternating current to defibrillate directly, and this type of defibrillator would always cause injury or death due to electric shock. Therefore, in addition to using alternating current for body defibrillation (ventricular fibrillation) during heart surgery, direct current defibrillation is generally used. It is a method of stopping ventricular fibrillation by delivering a certain amount of electrical current to the heart. If the chest has been opened, the electrode plate can be placed directly on the inner wall of the atrium for high-voltage shock, which is called intracardiac defibrillation. The one with the electrode plate placed on the sternum for high-voltage shock is extracardiac defibrillation. Then, what are the indications for electrical defibrillation?

First, Indications:

1, Ventricular fibrillation and ventricular flutter are the most critical indications. There is also rapid ventricular tachycardia that cannot be identified as R waves, because it cannot be synchronized with direct current power source for electrical cardioversion, and only non-synchronized high-voltage shock (equivalent to defibrillation) can be used.

2, Suitable for converting various rapid arrhythmias, especially those treated with drugs that have failed. Conversion of ventricular fibrillation, atrial fibrillation, and flutter can be preferentially selected for electrical defibrillation; conversion of ventricular and supraventricular tachycardia usually uses drugs or other treatments first, and this method is used when ineffective or accompanied by significant hemodynamic obstruction; for rapid arrhythmias with unclear characteristics or high incidence in patients with pre-excitation syndrome, drug treatment is often difficult, and synchronized electrical cardioversion should be used. The timely conversion rate of rapid arrhythmias through electrical cardioversion is basically 100% for ventricular tachycardia and atrial flutter, and 80% and 90% respectively for supraventricular tachycardia and atrial fibrillation.

Second, Contraindications:

1, Chronic atrial fibrillation, history of illness > 1 year.

2, Chronic rheumatic heart disease patients, left atrial diameter > 45mm, or severe insufficient cardiac function.

3, Combined digoxin poisoning or severe hypocalcemia (such as hypokalemia).

4, Active stage of rheumatoid arthritis or acute symptoms of myocarditis.