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Treatment Overview
Electrical cardioversion is a procedure in which an electric current is used to reset the heart's rhythm back to its regular pattern (normal sinus rhythm). The low-voltage electric current enters the body through patches applied to the chest wall.
Before cardioversion for atrial fibrillation, you will be given medicine to control pain and cause relaxation.
For non-emergency cardioversion, the timing of when you have it depends on how long you have had atrial fibrillation and your risk of having a stroke.footnote 1
- If you have had atrial fibrillation for less than 48 hours, your doctor might perform cardioversion right away.
- If atrial fibrillation has lasted for more than 48 hours, or you are not sure how long you have had it, cardioversion could cause a stroke. You will likely wait a few weeks before having the procedure. During this time, you will take an anticoagulant medicine to lower your risk of a stroke.
In some cases, such as an emergency, your doctor might do a transesophageal echocardiogram before a cardioversion to see if you have a clot in your heart that could cause a stroke. Then your doctor can decide when it is safe for you to have cardioversion.
For help deciding if you should have electrical cardioversion, see:
See pictures of:
What To Expect After Treatment
After cardioversion, you will be monitored to make sure that you have a stable heart rhythm.
You will likely take a medicine (called a blood thinner) that prevents blood clots for at least a few weeks after your cardioversion. This medicine lowers your risk of a stroke.
Additional medicines to help prevent the return of heart rhythm problems (antiarrhythmics) also may be given before and after the procedure. Your risk of having atrial fibrillation again is greater if antiarrhythmics are not used after cardioversion.
Why It Is Done
Cardioversion is used:footnote 2
- As a non-emergency procedure to stop atrial fibrillation that has not stopped on its own. For people who have just started having episodes of atrial fibrillation, treatment typically includes cardioversion.
- As an emergency procedure if atrial fibrillation is causing your heart to pump dangerously fast or causing your blood pressure to drop dramatically.
How Well It Works
The success of electrical cardioversion depends on how long you have had atrial fibrillation and what is causing it. Cardioversion is less successful if you have had atrial fibrillation for longer than 1 year.footnote 3
After this treatment, about 9 out of 10 people get back a normal heart rhythm right away.footnote 4 But for many people, atrial fibrillation returns. Normal rhythm may last less than a day or for weeks or months. It depends on your other health problems.
Staying in a normal rhythm is more likely when the cause of your rhythm problem is not another heart problem. But for most people, atrial fibrillation is caused by another heart problem and is very likely to return.
If your atrial fibrillation returns, you may be able to have cardioversion again. But you might not stay in a normal rhythm for very long. If atrial fibrillation comes back quickly (within a week or so), having cardioversion a third time, or more, is less likely to help you. Your doctor might recommend a different treatment, such as a rhythm-control medicine, to get your heart rhythm back to normal.
If you take antiarrhythmic medicines too, they can help you stay in a normal rhythm longer.
Cardioversion may be less successful or may not be recommended if you:
- Have had atrial fibrillation for more than a year.
- Have significant valve problems.
- Have an enlarged heart as a result of heart failure or cardiomyopathy.
- Have multiple recurrences of atrial fibrillation.
Cardioversion is more likely to be successful if:
- Atrial fibrillation has been present for less than a year.
- This is your first episode of atrial fibrillation.
- You are young.
- Antiarrhythmic medicines are used along with cardioversion.
Risks of the procedure include the following:
- A blood clot may become dislodged from the heart and cause a stroke. Your doctor will try to decrease this risk by using anticoagulants or other measures.
- The procedure may not work. You may need another cardioversion or other treatment.
- Antiarrhythmic medicines used before and after cardioversion or even the cardioversion itself may cause a life-threatening irregular heartbeat.
- You could have a reaction to the medicine given to you before the procedure. But harmful reactions are rare.
- You can get a small area of burn on your skin where the patches are placed.
What To Think About
Cardioversion can also be done with medicines. These medicines are called rhythm control medicines, or antiarrhythmics. These medicines can also help keep your heart in a normal rhythm after it has been reset. You may get pills, or the medicine may be put into your arm through a tube called an IV. If an IV is used, it will be done in the hospital. You may start pills in the hospital and continue taking them at home, or you may start the pills at home.
- January CT, et al. (2014). 2014 AHA/ACC/HRS Guideline for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation, published online March 28, 2014. DOI: 10.1161/?CIR.0000000000000041. Accessed April 18, 2014.
- Kerber RE (2011). Indications and techniques of electrical defibrillation and cardioversion. In V Fuster et al., eds., Hurst's The Heart, 13th ed., vol. 1, pp. 1088–1093. New York: McGraw-Hill.
- Fuster V, et al. (2011). 2011 ACCF/AHA/HRS focused update incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 123(10): e269–e367.
- Morady F, Zipes DP (2015). Atrial fibrillation: Clinical features, mechanisms, and management. In DL Mann et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 10th ed., vol. 1, pp. 798–813. Philadelphia: Saunders.
Current as ofJuly 22, 2018
Author: Healthwise Staff
Medical Review: Rakesh K. Pai, MD - Cardiology, Electrophysiology
Brian O'Brien, MD, FRCPC - Internal Medicine
E. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine
John M. Miller, MD, FACC - Cardiology, Electrophysiology
Current as of: July 22, 2018
Author: Healthwise Staff
Medical Review:Rakesh K. Pai, MD - Cardiology, Electrophysiology & Brian O'Brien, MD, FRCPC - Internal Medicine & E. Gregory Thompson, MD - Internal Medicine & Adam Husney, MD - Family Medicine & Martin J. Gabica, MD - Family Medicine & John M. Miller, MD, FACC - Cardiology, Electrophysiology


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Former Steeler with dementia found after search
Raymond Mathews, 84, didn't return from walk Tuesday afternoon in Marion Township
State police have found an 84-year-old former member of the Steelers who has dementia and was reported missing after not returning from a walk.
|| Watch the latest Video Report | View the Photo Gallery ||
Troopers from the Butler barracks said Raymond Mathews was found Wednesday morning next to a creek in a wooded area near his Marion Township home. He had been missing for about 20 hours and spent the entire night outside as temperatures dipped into the 30s.
"I'm very relieved. We're very fortunate to have found him in the condition he's in. He's in better shape than most of us," said Mathews' grandson, Lucas Prior.
Mathews' wife, Ruth, said she's "elated" and that her husband was "very lucky."
"It was terrible, probably the worst night of my life," she said. "(I) could never be any worse than last night."
Mathews was taken to a nearby hospital as a precaution.
Mathews was last seen walking in Marion Township about 2:20 p.m. Tuesday. Searchers couldn't find him later that day, and resumed looking for him about 9:30 a.m. Wednesday.
Mathews was a wide receiver for the Steelers for nine seasons from 1951 to 1959 after playing at Clemson University.

subset: commoncrawl


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Mayor Bloomberg returned to "Late Night With Jimmy Fallon" on Thursday armed with quips about the Knicks and sharing a stage with the Rockettes on New Year's Eve. He also tackled more serious topics like relief aid for Sandy victims and gun control in the wake of the Sandy Hook school shooting in Connecticut.
In his third appearance on the NBC late-night talk show, Bloomberg and Fallon tallied up the mayor's recent accomplishments: a controversial soda ban, a 311 iPhone app, new bike lanes and a tourism boom in New York City that includes a record 52 million visitors in 2012.
The two also talked about the work ahead. The mayor urged the audience to take action.
U.S. & World
"Call your congressmen and senators and say 'I'm not going to take this anymore and I'm going to vote for whoever is running against you unless you do something,'" the mayor said.
Bloomberg, however, took on a less defiant tone with House Speaker John Boehner's decision to delay action on a Sandy relief package.
"We will get the relief, I am convinced," Bloomberg said. "Boehner has promised to do it, but I can't tell him how to run the House and he's not trying to tell us how to run the city."
The two gabbed about bringing the Nets to Brooklyn and ringing in the New Year with the Rockettes.
"You were probably jealous, because there I was, on stage with millions of people watching me, with 10 of the Rockettes," he told Fallon. "But I couldn't get my legs up as high as them."
Fallon garnered some laughs when he presented computer generated images of the mayor on the courts playing for the Nets on opening day. Another CGI picture showed Bloomberg as godfather to Jay-Z and Beyonce's daughter Blue Ivy.
"Actually, I'm waiting on a call from Kanye and Kim," the mayor joked.


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|Roll Number:
|sc up
|Candidate Name:
|Father Name:
|Sunil Kumar
|Date of Exam:
|10:00 AM to 12:30 PM
|Center of Examination:
|Uttarakhand Sanskrit University, Haridwar
NH-58, BHEL More, Bahadrabad Haridwar - 249402, Uttarakhand, India
1. Candidate without Admit Card shall not be allowed in the examination under any circumstances.
2. Candidates should bring good quality BLUE/BLACK ball point pens for the examination. USE OF PENCIL IS STRICTLY PROHIBITED.
3. Communication Devices like Cellular Phone/Pager/Docupen etc. And Textual materials is strictly prohibited in the Examination Hall.
4. The Admit Card is issued provisionally to the candidate as per the information provided by him/her.


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49 members64 Comments 8 Likes
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Mordekhai ben-Yosef has not received any gifts yet
Welcome, Mordekhai. I agree that obedience to gods makes believers perform acts of hateful bigotry. I want no part of that either. Religions pretend to be inclusive by trying to convert others to their way of thinking. But if you don't agree with their way of thinking, you are quickly excluded.
Hi Mordekhai ben-Josef
Welcome to this world of rationality, truth and peace, where common sense and science lead to freethinking wisdom --- as you know as a long time non believer and freethinker like us.
We invite you to make good friends by joining the busy group "ORIGINS: Universe, Astronomy, Life, Earth, Humans, Religion, Gods, Atheism, Evolution, Darwin..." with 700 discussion topics and 3500 members.
Welcome, Mordekhai! Glad you could join us. :D
Please consider joining a group to meet people and talk about anything that's on your mind, Hang With Friends. You might also like Jewish Atheists.
I also recommend Eco-Logical and Climate Concerns, since New Jersey's climate is changing.
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Policy Basics: Where Do Federal Tax Revenues Come From?
The three main sources of federal tax revenue are individual income taxes, payroll taxes, and corporate income taxes. Other sources of tax revenue include excise taxes, the estate tax, and other taxes and fees.
June 20, 2019
In fiscal year 2018, the federal government spent $4.1 trillion on the services it provides, such as national defense, health care programs like Medicare and Medicaid, Social Security benefits for the elderly and disabled, and investments in infrastructure and education, in addition to interest on the debt (see our related Policy Basics: Where Do Our Federal Tax Dollars Go?). Federal revenues financed over $3.3 trillion of that $4.1 trillion. Borrowing financed the remaining amount ($779 billion); future taxpayers will ultimately pay this deficit.
Half of all federal revenue (51 percent) comes from individual income taxes. The income tax is generally progressive: higher-income households pay a larger share of their income in income taxes than lower-income households do.
Another 35 percent of revenue comes from payroll taxes, which are assessed on the wage or salary paychecks of almost all workers and are used to fund Social Security, Medicare Hospital Insurance, and unemployment insurance. By law, employers and employees split the cost of payroll taxes, but research has shown that employers pass their portion of the cost on to workers in the form of lower wages.
Payroll taxes as a whole are regressive: they collect a higher percentage of total earnings from lower-income workers than higher-income ones. However, if one looks at the overall impact of Social Security, Medicare, and unemployment insurance — the benefits they provide as well as the taxes they collect — these programs are progressive. (See our related Policy Basics: Top Ten Facts About Social Security and Policy Basics: Federal Payroll Taxes).
Corporate income taxes make up about 6 percent of federal revenue, with the remaining 8 percent coming from excise taxes, estate taxes, and other revenue sources. Excise taxes are collected on the sale of certain goods (e.g., fuel, alcohol, and tobacco); they are intended to raise revenue and, in some cases, discourage consumption of the taxed product. These made up about 3 percent of federal receipts in 2018.
The estate tax is a tax on assets such as cash, real estate, or stock that are transferred from deceased persons to their heirs. Because the first $22.4 million of a married couple's estate was exempt from the estate tax in 2018, and due to other special exemptions from the estate tax, fewer than 1 of every 1,000 estates owed the estate tax in 2018. Because it affects only those who are most able to pay, the estate tax is the most progressive component of a tax code. Estate tax revenues made up 0.7 percent of total federal receipts in 2018.
Another source of federal revenue is profits on assets held by the Federal Reserve System. These were about 2.1 percent of total revenue in 2018, compared to a recent low of 0.9 percent in 2005. The increase in these receipts is due to extraordinary actions taken by the Federal Reserve to combat the financial crisis and is projected to decline in the coming years.
The small remainder of federal revenues comes from various sources such as regulatory fees and custom duties.
Over recent decades, the share of federal revenues coming from individual income plus payroll taxes has grown, while the share coming from corporate taxes and other revenues has fallen. The Great Recession — one of the worst economic downturns since the Great Depression — and the policies enacted to combat it, including temporary tax cuts, depressed federal revenues below the typical levels of recent decades. Revenues fell from 18.0 percent of gross domestic product in 2007 (the last fiscal year before the recession) to 14.6 percent in 2009 and 2010. Revenues have recovered with the economy and were 16.5 percent of gross domestic product in 2018 — well below the prior 40-year average of 17.4 percent of GDP — largely due to the enactment of the 2017 tax law.


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Hello Folks,
Long time since I visited here, so I hope nobody will mind if I return with a question, well two actually.
I've found a photo on Flickr, which shows a train of skips on the Easton Hall railway, with what looks like a petrol loco in the middle of the rake. To me, it looks like a Stansteco/Jung loco, with sloping bonnets at each end, but it is very hard to see. Does anyone know whether this is one of the two Simplexes "in fancy dress", or something else?
Secondly, the first petrol loco used at Blakesley Hall, before Blacovesley was built; does anyone have anything resembling a drawing showing how it was arranged? To me, it looks like an Otto/Crossley engine on a chassis, but I'm not even sure about that, and the transmission layout I can't make out from photos.
Many thanks in advance, Kevin