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Out‐of‐hospital cardiac arrest (OHCA) is a major cause of death worldwide. Cardiac arrest occurs when the rhythm of the heart becomes disorganized and the heart becomes ineffective at pumping blood to the rest of the body. Prolonged periods of reduced oxygen to the brain can cause permanent damage. Cardiac arrest can be caused by, but is different from, a heart attack (myocardial infarction).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 12, 2014

Electrical cardioversion is a procedure by which pads on the chest aim to return the heart to a normal rhythm following disturbances. This procedure is painful and can be distressing for the patient; therefore drugs are used to make patients unaware of the procedure. We aimed to compare the safety and effectiveness of the drugs used in electrical cardioversion.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 22, 2015

People with atrial fibrillation can have treatment to restore a normal heart rhythm, either through medication or weak electric shocks. The medical term for this kind of treatment is cardioversion. If the normal heart rhythm can’t be stabilized with medication afterwards, a treatment known as catheter ablation may be considered. In atrial fibrillation, there is a problem with some of the signals that set the pace of the heart. This typically leads to a fast and irregular heartbeat, which can cause symptoms such as palpitations, shortness of breath and exhaustion. Treatment with medication (pharmacological cardioversion) or controlled electric shocks (electrical cardioversion) can often restore a normal heart rhythm. Afterwards, medication is typically used in order to try to prevent the heart rhythm from becoming irregular again. Even if a normal heart rhythm (sinus rhythm) can be successfully restored through cardioversion, people still sometimes have to take medication to lower their pulse.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 5, 2017

When a person's heart stops beating it may be necessary to deliver an electrical shock (called 'defibrillation') to the person's chest to restart their heart. Two electrodes are placed on the person's chest to allow the defibrillator to deliver the electrical shock. Historically, the electrical current applied to the chest has travelled in one direction between the electrodes. More recently, defibrillators have been designed to send the electrical pulse in one direction and then in the reverse direction. This is known as a 'biphasic' waveform.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: February 10, 2016

Atrial fibrillation is a disease where the heart rhythm is irregular (this is called arrhythmia) and too fast (this is called tachycardia, from the Greek tachy meaning fast). Atrial fibrillation may produce complications, either in the heart (heart failure, syncope) or in other organs (mainly causing embolism, the formation of blood clots in the cavities of the heart that may then travel to other places, for example the brain).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 28, 2015

Atrial fibrillation is a heart condition that causes an irregular and often abnormally fast heart rate (tachycardia). A normal heart rate should be regular and between 60 and 100 beats a minute when resting. In atrial fibrillation, the heart rate is irregular and can sometimes be very fast. In some cases, it can be considerably higher than 100 beats a minute. This can cause symptoms such as dizziness, shortness of breath, and tiredness that affect quality of life, but more importantly, atrial fibrillation increases the risk of suffering a stroke.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: November 22, 2016

In atrial fibrillation, the rhythm of the heart is irregular and the heart usually beats faster than normal. The high pulse can be reduced with medications such as beta blockers. There are also treatments that aim to restore and maintain a normal heart rhythm. These are most suitable for people who have severe symptoms. If someone has atrial fibrillation, trying to restore a normal heart rhythm (sinus rhythm) may sound logical at first. But even if this treatment works, sooner or later most people go on to develop atrial fibrillation again – sometimes without noticing it. And the treatments that are used to restore the sinus rhythm are associated with side effects and risks, including the risk of serious complications. So it is worth carefully considering the pros and cons of this treatment together with your doctor. It's important to know that even if your heartbeat returns to a normal rhythm after treatment, you are still at higher risk of having a stroke. Because of this, people often still need to carry on taking anti-clotting medication (anticoagulants).

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 5, 2017

People with atrial fibrillation have two main treatment options: Treatment to restore their heart rhythm or treatment to control their heart rate. Studies have shown that there are no differences between these treatment approaches in terms of life expectancy and the risk of developing medical conditions associated with atrial fibrillation.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 5, 2017

How do beta blockers compare in hypertension?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: October 1, 2010

Supraventricular tachycardia (SVT) is a common heart abnormality that presents as a fast heart rate. This heart rhythm disturbance can occur in healthy individuals and may include such symptoms as chest pain, palpitations, shortness of breath, sweating, and feeling faint. In rarer instances, unconsciousness may occur. The treatment of SVT is usually a combination of physical straining manoeuvres (also known as vagal manoeuvres), medications, or electrical therapy (used in severe cases where blood pressure drops to a low level). A vagal manoeuvre is a term used to describe any physical intervention that results in stimulation of the 10th cranial nerve (vagus nerve), which in turn can lead to slowing of the heart rate in the setting of SVT. One such manoeuvre, the Valsalva Manoeuvre (VM), is performed by having a patient blow into a syringe whilst lying down (face up) for 15 seconds. This generates increased pressure within the chest cavity and triggers a slowing of heart rate that may stop the abnormal rhythm. This review examined the available evidence to see how effective the VM is in restoring normal heart rate (known as reversion success). This is an updated version of the original review published in 2013.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: February 18, 2015

We wanted to find out whether midazolam makes medical procedures more comfortable for children and adults, as well as whether it makes the procedure easier to perform.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: May 20, 2016

People who undergo heart surgery may have an abnormal heart rhythm disorder known as atrial fibrillation, which increases the risk of developing a stroke. Some patients may experience symptoms of palpitations, and many patients are recommended to take blood thinners to reduce their risk of having a stroke. Many surgeons will offer patients a procedure to treat this heart rhythm disorder at the same time of a heart surgery.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: August 22, 2016

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