when monitor won't synch

[zzyzx]

In what circumstances might it not be possible to synch before cardioverting? Very rapid AF?

In this situation, would it be okay to instead defib at a high energy (i.e., 200 J)?

[Ridryder 911]

Usually the monitor will not synch when the "R" wave is not upright or not high enough, turn up the gain or height, or change lead positions.

Cardioversion does not detect the rhythm or "p" waves, rather the upright tall R waves. I have seen rats > 250 able to be synchronized. Some cardiologist much rather "defib" one and clear all refractory period than to attempt to cardiovert and have a chance of ventricular fibrillation to occur.

AHA does describe if a patient is too symptomatic and one thinks it will take to long to cardiovert, defibrillation is acceptable, in severe cases.

R/r 911

[ERDoc]

Usually the monitor will not synch when the "R" wave is not upright or not high enough, turn up the gain or height, or change lead positions.

Cardioversion does not detect the rhythm or "p" waves, rather the upright tall R waves. I have seen rats > 250 able to be synchronized. Some cardiologist much rather "defib" one and clear all refractory period than to attempt to cardiovert and have a chance of ventricular fibrillation to occur.

AHA does describe if a patient is too symptomatic and one thinks it will take to long to cardiovert, defibrillation is acceptable, in severe cases.

R/r 911

You've been able to synchronize over 250 rats! I can't get two to stand still at the same time. Rid, you never fail to amaze me.

[Just Plain Ruff]

Rid is that similar to synchronized swimming? Synchronized ratting???

[zzyzx]

I guess I'm partially answering my own question, but I remember now that Torsades sometimes can't be synched. What about a very fast A Fib?

[AZCEP]

Two distinctly different situations there.

Torsade is difficult to synchronize due to the changing deflections of the R wave. The monitor has a difficult time deciding what is an R and what isn't, so it won't sync with every one.

With AF, even at fast rates, the R wave tends to be of the same deflection. Even the irregularity that occurs doesn't usually hinder the sync mode from flagging the R. Also as AF speeds up it tends to become more regular, due to the rate of repolarization being sped up as well.