Why the study?
Does direct current cardioversion cause acute pulmonary edema in patients with atrial arrhythmias and severe left ventricular disease?
Does direct current cardioversion cause acute pulmonary edema in patients with atrial arrhythmias and severe left ventricular disease?
Direct current cardioversion may precipitate acute pulmonary edema and death in patients with atrial arrhythmias and severe underlying left ventricular disease.
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Suggests post-cardioversion pulmonary edema risk in severe LV disease; hypothesis-generating case series leaving causality open.
Three patients developed acute pulmonary edema shortly after direct current cardioversion for atrail arrhythmias. All patients had marked left ventricular enlargement and evidence of left ventricular failure prior to cardioversion. Each patient received a single low-intensity shock. Two patients recovered, but the third failed to respond to intensive medical treatment for pulmonary edema, and death resulted. Cardioversion may result in critical depression of left ventricular function and may not be indicated for the treatment of atrial arrhythmias in the presence of severe disease of the left ventricle.
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J. Budow (1971) studied this question.
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