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2012, Número 3

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Rev Mex Cardiol 2012; 23 (3)


La cardioversión eléctrica en fibrilación auricular

Velázquez-Rodríguez E

Idioma: Español
Referencias bibliográficas: 116
Paginas: 134-150
Archivo PDF: 234.19 Kb.


RESUMEN

La cardioversión eléctrica para el tratamiento de la fibrilación auricular (FA) se introdujo en la década de los 60 y se mantiene actualmente como el tratamiento más efectivo y seguro para la conversión a ritmo sinusal. El método óptimo para la cardioversión eléctrica de la FA incluye tanto la selección del paciente adecuado como una técnica de cardioversión eléctrica apropiada. Los factores que han sido implicados en el éxito de la cardioversión eléctrica transtorácica incluyen aquéllos relacionados con: 1) la presencia de cardiopatía; 2) el habitus corporal del paciente; 3) la energía proporcionada; 4) la forma de onda eléctrica proporcionada, y 5) misceláneas. En vista de las consecuencias hemodinámicas y tromboembólicas, la conversión a ritmo sinusal puede esperarse que reduzca o suprima los síntomas y morbimortalidad asociadas con la FA. El éxito de la cardioversión eléctrica es alto de acuerdo al paciente seleccionado y la frecuencia de recurrencia inmediata o tardía postcardioversión puede ser alta y se requiere el uso de antiarrítmicos especialmente en presencia de comorbilidad como insuficiencia cardiaca o hipertensión descontrolada. El objetivo del tratamiento antiarrítmico concomitante es aumentar la posibilidad de éxito y prevenir las recurrencias, el cual debe considerarse de manera individual tomando en cuenta sobre todo el tiempo de evolución de la FA y la presencia y severidad de la cardiopatía. La posibilidad de cardioversión eléctrica exitosa en más probable en FA de corta duración y ausencia de cardiopatía.


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