Notes On The Rhythm Control

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2.5.3. Rhythm Control Cardioversion

Usually performed electively, cardioversions are procedures that are performed to convert an arrhythmia back to sinus rhythm.. There are two types of cardioversions; pharmacological and electrical.

Pharmacological cardioversions are performed via administering arrhythmia-medication to patients to restore the heart’s rhythm to normal sinus rhythm. Pharmacological cardioversions were the standard cardioversion procedures performed before electrical cardioversion became more commonly used. Advantages of pharmacological cardioversions are such that the procedure does not require sedation, (whereas electrical cardioversion does), and the development of new drugs has made it more of a popular
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The main risk associated with DC cardioversion is the occurrence of embolic events and cardiac arrhythmias (Fuster V et al; 2001). Surgical Ablation – Cox Maze Procedure

James Cox, along with his colleagues, developed the Cox Maze procedure, (also known as the Maze procedure) which is an open-heart surgical procedure designed to eliminate AF. The procedure consists of creating conduction barriers within the RA and LA, thus limiting the number of wavelets able to propagate themselves within the atrial myocardium, thus eliminating AF.

A five-year follow up study was conducted to assess whether the Cox Maze procedure was a viable treatment option for AF patients. The sample size consisted of 75 patients who had undergone the maze procedure for the treatment of AF. At the end of the five years, 65 patients had been followed up for three months post-procedure. The end result was that the Maze procedure was successful in treating AF in 98% (n = 64) of the 65 patients followed up. It was also successful in treating AF without the need for medication in 89% (n = 58), and with the need for medication in 9% (n = 6) of the total cohort respectively. This therefore proves that the Cox maze procedure is an effective treatment method for AF patients (Cox JL et al; 1993). Catheter Ablation

As a result of the success of the Cox Maze procedure, catheter ablation strategies were developed in an attempt to replicate the
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