Patients admitted to the coronary care unit or arrhythmia department often present with one of numerous heart rhythm disorders. Some of the arrhythmias are not life-threatening (e.g. atrial fibrillation), whereas ventricular tachycardia and ventricular fibrillation are potentially life-threatening conditions, when medical team must react appropriately in the shortest possible time. It is important to note that atrial fibrillation and atrial flutter do not occur solely in coronary patients but may also occur in young individuals without structural heart disease. The aforementioned arrhythmias are mentioned, since they can be converted by electrocardioversion. Ventricular tachycardia occurs only in patients with underlying cardiomyopathy or coronary heart disease. There is an exception to the rule when ventricular tachycardia presents in “the healthy heart” (very rare conditions, e.g. prolonged QT interval syndrome).
Defibrillation is a process of electrical energy delivery to the heart muscle with intent to interrupt ventricular fibrillation or tachycardia. Synchronized electroconversion is a modified form of defibrillation applied in atrial fibrillation or atrial flutter with the fast ventricular response, with the intention of restoring the sinus rhythm. Electroconversion can be urgent, or elective. Preparation of patients for elective synchronised electrocardioversion involves psychological and physical preparation. Electrocardioversion is a procedure that requires team work of cardiologists, anesthesiologists and nurses. It is necessary to approach the patient and perform the work professionally, explain the procedure to a patient, give clear answers to the questions posed and provide support during the procedure. In order for nurses to participate as equal members of the team in this, and also in other procedures, continuous nursing education is needed. (