Elektriksel Kardiyoversiyon
Özet
Elektriksel kardiyoversiyon (EKV), taşiaritmilerin acil ve elektif tedavisinde kullanılan, senkronize doğru akım şokuna dayalı etkin bir yöntem olarak ele alınmaktadır. EKV; atriyal fibrilasyon (AF), atriyal flutter (AFI), paroksismal supraventriküler taşikardiler (AVNRT, AVRT) ve nabızlı monomorfik ventriküler taşikardilerde yüksek başarı oranları ile uygulanabilmektedir. Literatürde özellikle AF ve flutterda %70–100’e ulaşan akut başarı oranları bildirilmiş, bifazik defibrilatör ve uygun elektrot yerleşiminin başarıyı artırdığı vurgulanmıştır. Bununla birlikte, işlem tromboemboli, anestezi/sedasyon komplikasyonları, cilt yanıkları ve aritmi tetikleme gibi riskler taşır; ayrıca uzun vadeli ritim kontrolü sağlamada tek başına yeterli değildir. Bu nedenle, hasta seçimi, uygun antikoagülasyon ve doğru teknik uygulama kritik önem taşır. EKV, hemodinamik instabilite durumlarında hayat kurtarıcı olup, çoğu zaman antiaritmik tedavi veya ablasyon gibi yöntemlerle kombine edilerek nükslerin önlenmesine yönelik bütüncül bir stratejinin parçası olmalıdır.
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