Dr. Bruce Janiak's Cardioversion from Atrial Fibrillation

[@brucetomaszewski7691]

Dr. Mellick, I felt honored watching this case. The history behind this man. I only wish I was talented enough to write his biography and the history or emergency medicine over the last 40 + years. I worked with a RN that retired about 8 years ago. She would tell me about the days in CCU when the patients were on bed rest for 5 days post MI, giving 20 mg of MSO4 as a single dose, and reusable needles pre HIV. This is an awesome tribute that he allows "HIS" ER staff to care for him vs EP. Was really an awesome video. I just watched it again and am in awe of this man. Thanks you for making my week!

[@lmellick]

Thank you for your kind words! I totally agree.

[@MegaCaprice123]

Watching this has made me feel more confident in having a cardioversion next week. I'm 76 years of age, a couple of years older than this gentleman. I will be put to sleep, which is a relief. I must confess I had thought of cancelling, I was frightened, but after seeing this brave man I think I will go through with it. I hope he is now fit and well.

[@lojey]

Hey man, how did it go?

[@carschmn]

Love how he worked a whole shift with heart issues. Hardcore!

[@emadalkean5134]

Dr Bruce Janiak you are an amazing person. it's inspiring that you have been serving medicine for long time and still up to date with everything.

[@lmellick]

Totally agree.

[@starstruck4eva08]

Can I please mention how beautiful it was to watch this video. It reminds me of everything that made me enter medicine. Thank you. He is brilliant.

[@lmellick]

Thank you!!

[@lindalarkman9869]

Wonderful. Thank you. I'm going ahead with my cardioversion. This doctor has allayed my fears. God Bless him. I'm 76 years old and not in good health, so I was worried. Better the devil you know I kept telling myself. Now, I going to have the cardioversion done next week. Hope you are well and fit, you are such a fine trooper. Thank you to the person doing the filming. A very professional approach. Well done everyone.

[@lmellick]

That is great news.

[@kristintucker9719]

Thank you so much for providing these videos! I can't tell you how much it helps to see real life scenarios over reading about them in a text book or listening to a lecture! Please keep it up!!

[@yoSomethingSpecial]

Dr.Mellick I am addicted to your youtube channel. I have transitioned as a RN from working at a outpatient dialysis clinic to an ER located in an urban region in N.J that never has a dull day. Your videos have helped immensely. Thank you in advance

[@lmellick]

Excellent! It really helps to hear comments like yours!

[@dk28355]

Kudos to Dr. Janiak for making cardioversion less scary for practitioners and patients. Great video.

[@lmellick]

Thank you.

[@badgerrinc1]

Dr. Janiak, thank you. I was told just yesterday that I need a cardioversion. It's scheduled for two weeks and I will admit that the whole situation is a bit upsetting. This video helped me understand it a bit more and ease my freaking out mind. Thank you for sharing this very personal situation.

[@barrywakser1794]

74, and he worked a whole shift with an arrhythmia and not having eaten anything. Glad he's doing better!

[@lmellick]

Pretty impressive guy!

[@nutrientcobra]

For a DR to do this on KZbin for people to learn is amazing! Good job!

[@MegaCaprice123]

I had my cardioversion done today and there was nothing to be frightened of. Instead of permanent AF, I now have an ectopic beat which I'm told is harmless. Thank you Dr Bruce, without your video I might well have cancelled. You are a great doctor. Thank you, too, to the Cardioversion unit at Musgrove Hospital, UK. You are all fantastic people. From start to end you were all so professional.⭐️⭐️⭐️ Beautiful Souls.

[@lmellick]

Excellent! Thank you for your comments.

[@nhhx3]

were you in and out? I suffer from extreme anxiety and don't know if i would even make the appointment!

[@sabunkompas]

Salute for dr. Janiak and whole team for allowing this video to be shared to everyone around the world. Love from Indonesia.

[@ddbrosnahan]

Great demonstration of managing the airway during a moderate sedation. Etomidate tends to cause less airway/respiratory issues but some patients will obstruct no matter what you use.

[@Navitron]

Guess the old saying of "Doctors make the worst patients" is wrong. Great video.

[@susiessoapstuff1459]

Thank you for this video. As an RN, I am far more comfortable with A-fib from the other side of the bed rail. Now I have it, and they scheduled my cardioversion today. Your straight-forward approach to this has calmed my anxiety a great deal. Again, thank you!

[@SuperGuanine]

Thank you A LOT Dr. Janiak for making this educational video - generous of you. i'm having a cardioversion next Wednesday - I have to stay in the hospital for 2 days before the procedure b/cuz they want me to take Tikosyn for the 2 days preceding the cardioversion which I think is to make sure I'm not in AFib when the cardioversion is done on the 3rd day. I am much less scared of the procedure thanks to Dr. Janiak, the technicians and the people who did the videotaping. What a TEAM!!!!!!!

[@hakunamatata365]

Wow... he was #1? That is amazing and major kudos to him taking that step. Great video!

[@lmellick]

Thank you!

[@ValerieSellers]

THANK YOU and THANK DR JANIAK - very helpful to see how short the period of anesthesia is when deciding on advisability of procedure in somewhat cognitively compromised 90 year old.

[@TonyMartin-n7y]

I was stuck in AFib for 2 months before they cardioversion had a fib all my life been shocked eight times already

[@nana-x9]

Dr. Mellick, What a fantastic thing to witness! Kudos to the entire ER staff & this wonderful ER doctor for allowing us to be a part of this. Oh, how I miss nursing so much. I had nothing but A+ care from my many times in MCG's ER from May 1997-March 2005, I was the "Excitement" during my first stay there. Transferring via ambulance from Aiken to the ER at MCG, I was a very, very sick lady, septic, weak, around 100 lbs. by then, & scared to death about having an ERCP done, the reason for me being there. The nurses calmed me with their care & meds that should have been prescribed to me before then, but they made sure they were then! I too was the "subject" that allowed photos to be taken during the hepaticojejuemostomy that very early Saturday morning May 17, 1997. Also, I was in the largest surgical room, at that time. After placing the epidural, for pain management for the first few days post-op, I then turned & laid back on the surgical table, & above me all the way around, were med students, interns, residents, & many others there to see my surgery. That's when it kicked in for me how big of a deal my surgery was!!! Of course, I choked up & in walked Dr. David Crist, my savior. He calmed me down & asked one of the nurses to keep an eye on me & help me stay calm. Afterwards, I realized how important the surgery was & I was so honored to play one of the most game this!!!!! Thank-you again for letting me share this wonderful memory. Thank-you for being involved in the cardiovertion & sharing it. My best to the doctor-patient. Blessings!! I love the cards I purchased a few weeks ago!! They are really great!

[@lmellick]

Excellent! Thank you so much for your comments. Glad you love the cards.

[@abdullaalhmoudi8729]

Thank you very much as usual and thanks to everyone in the video. I solidify my learning of text books by watching your videos; very entertaining.

[@airportnurse3380]

Are there annual teaching awards for physicians? If so, Dr. Janiak should be awarded one!

[@YungNFreudened]

Thank you for allowing your cardioversion to be filmed. Very educational.

[@oOoironhideoOo]

Thank you so much for the video! Is really great to see the whole process, from the patient encounter to the therapeutic procedures :)

[@lmellick]

You are welcome!!

[@Maria-qm9cg]

Thanks so much for taking time to teach Dr Bruce, and all involved in making this video possible, great educational video.

[@TheJerrydon575]

This actually made me tear up. I went to the E.R. in 2016 for what I thought was the flu. Turns out I was in AFIB so they admitted me. My blood pressure was all over, the doc's kept saying stop that. I was n there for 4 days when they wheeled me to get a cardioversion. At the last minute another Dr came in and found out my Thyroid was 7X overactive. They didn't do the cardioversion. 6 months later I got the cardioversion and I felt like a million bucks! Since then I have had a thyroidectomy, and have been taking my meds. No afib, no weird internal set backs! I will admit the cardioversion was the scarest thing. And I had some burns from it. When I woke up from it my wife was crying, that worried the hell out of me. But, they were tears of joy. Long story short, if Dr's recommend a cardioversion, do it! You will feel so much better!!!!

[@coupmd]

Dr. Mellick, I very much enjoy your videos and appreciate the effort you put forwards to make them!

[@lmellick]

Thank you. They are a lot of work, but definitely worth the time.

[@nsas955]

Thank you very much. Yet I used to do cardioversion in case of AFib with rapid ventricular response only NOT with slow ventricular response. This is new to me. Thank you.

[@billwoolfolk370]

I’m about to be 59 and I had no idea I had AFib. It was found during an annual physical. This procedure was amazing. Other than a bad sore throat from the camera sent down my throat , it was painless.

[@robertorion6559]

I have had two. I wish I had seen this video before hand! I hope it puts someone's mind at ease before hand.

[@VBfamilyadventures]

I have a cardiac disorder test coming up. This is a great video! Incredibly informative. I shared this with my classmates.

[@lmellick]

Excellent! Thanks.

[@RobsKoiPond]

Great vid doc. I had a sudden onset of Svt and my hr went to 250 bpm. This happend to me twice in a 2 year period. Dx was WPW syndrome. Went through the same Tx as this physician and had 3 shocks to bring me back to NSR. 2nd occasion a year later I was given adenosine (liquid death as I like to call it lol) I would've rather been cardioverted. I live in Canada and went through a successful cardiac ablation procedure 6 months later and am as good as new. This is a great video and I can also say to anyone don't be afraid if this happens to you. You won't feel a thing.

[@lmellick]

Thank you and thank you for your comments.

[@personincognito3989]

🇨🇦 same

[@kokoronai594]

I don't need to have this done (I don't meet the necessary prerequisites), but your confidence is inspiring! Thank you!

[@bigjohn7057]

I had this done about three years ago. If you have to have it done, do not be too alarmed. From the minute I woke up. I felt great, and I have been in sinus rhythm ever since.

[@KirstieXoXo]

Wonderful video! So much respect for you and Dr. Janiak!

[@lmellick]

Thanks Lovena!!

[@andrewcomments5812]

Nice video as usual, Doc! Blessings to Dr. Janiak!

[@JeffSpehar-ov1cn]

My brother was in the ICU for almost a month with CHF/AFIB of 170-200 bpm. He also had severe COPD. After weeks of medication and unsuccess at lowering his heart rate they did a Cardio ablation with inserting a pacemaker. A few weeks in rehab and he went home. He has been home for over a year now with no complications.

[@shawnbenoit3774]

is he on any oxygen?

[@Mishel33020]

Thank you so much. I am in my last semester of nursing school and we are taking cardio.. Its one thing to read about it, but another to watch. Thank you so much.

[@teenawillis682]

Must be comforting to know exactly whats being done to you.

[@Momo-bb2fn]

Or horrifying when you know it’s going wrong

[@marilyndevault4819]

Yes and no…..

[@GeorgeDaymondLush]

This was excellent. I have just had cardioversion in Watford General in the UK but made the mistake of watching some of the bad KZbin clips and so I had a "discussion" with my gas man when I told him I wanted alfentanil in the "anaesthetic mix". Being the good lad he was he certainly did and I was back on the ward in 10 minutes after a pain-free burn-free return to sinus rhythm . I should have only watched this vid. I have to add that in the UK as with all procedure/surgery/intervention mine was free of any charge. Even got a chicken sandwich and some fabulous and funny nursing .

[@andythurlow1614]

This has given me confidence to go for mine later this month. Thanks for the video

[@ahmedsalama8463]

Thank you so much......please more &more teaching videos including anesthesia....sedation etc because very helpful very valuable....indications,,,absolute contraindication...be ready for the worst in reasonable time....not long.....again wonderful video

[@lmellick]

Thank you, I will

[@bmurphr1]

Wonderful video Dr. Mellick, and very articulate from your end as well as Dr. Janiak because the two of you together explained everything in explicit detail as well as helped to alleviate any doubts that future viewers might have about cardioversion as most people believe that the idea of electrical current passing through your body is extremely painful and you feel every bit of it when in fact the propofol even though it doesn't have much analgesia does make you amnesic to the point that you forget you were even cardioverted in the first place. It might be painful, but the pain goes away instantly before the propofol wears off and it enables people to go home immediately after the procedure without feeling groggy or ill. The only thing I would have mentioned is that some people don't tolerate propofol as well as others, as people will sometimes go out and grab something to eat right after only to vomit it back up later which is never fun. Usually after I've been sedated with propofol the next meal I have will be something light and small just in case vomiting occurs, but after you take it easy for 8 hours or so there's no reason you can't have a normal meal...that's my only "food" for thought. Cheers Dr. Mellick and thank you for sharing this video with all of us!

[@lmellick]

Thank you for your comments!!

[@dandeprop]

Absolutely outstanding! Thanks to Dr. Janiak for his kind consent.

[@briantracy271]

Amazing doctor ,love his confidence

[@WattsyID]

I’m 54 and in pretty good shape Typically my resting heart rate is around 60. The other day my heart rate was up around 160 so I wenr to emergency department and they did this to me. I was fortunate that I had no idea what they were going to do to me. Not painful and nothing to worry about about.

[@AM-bj7yo]

Thank you for this, please keep them coming, it’s extremely informative, especially for Med students!!

[@chrismenjou3305]

Getting ready to schedule mine. This is a great help

[@ReclusiveMountainMan]

Cool video. Glad Dr. Janiak is better. Should I ever need this procedure, I'll be much more comfortable. Don't currently have a-fib, but there is a family history.

[@lmellick]

This video definitely should make people more comfortable with the procedure. Thank you.

[@sarahchoi9175]

Thank you for this video. This was very helpful education. Hope Dr. Janiak is well.

[@GrannyLaLa1960]

Very informative. I was under cardiologist care for over 10 years for valve issues. Then developed afib and my doctor caught it. He put me in warfarin for a few days and scheduled me for a cardioversion. But they found that I'd gone Back to normal. I was admitted and out on medication. A few years later drunk driver hit me & husband. We survived but my husband has permanent flail chest one side, 4-12 ribs gone. Lost job, lost insurance and I can't afford Obamacare, don't qualify for Medicaid because my husband makes a few dollars too much on his SSDI and tiny pension. So lay in bed with my heart pounding, fluttering and feel so tired. I take aspirin and wait for the big stroke. Told my husband no life support and no medical intervention. To let me go. I can't get SSDI because I had quit working & going to college full time. They lapsed any credits before the 10 years require of work credits so I'm short on that. What will be will be.

[@lmellick]

Sorry to hear that you are down on your luck. Glad the video was helpful.

[@D-Imagine]

Great info video, thanks for sharing. I'm a survivor of a massive heart attack with ruptured left ventricle at the same time on September 11, 2018. I am doing great after surgery. I am starting Cardio Rehab tomorrow

[@RetiredSignDude]

I did this last week, exc. I had the TEE variety. As easy for me as it was for him.

[@peternewman3487]

I had this done on Saturday 12-01-2019, Absolutely marvellous and now I’m afib free.

[@housbinpharteen7445]

ARE YOU STILL AFIB FREE IN 2023?

[@JoelWelter]

Another great video. If I may voice a concern, why did the nurse have to remind the resident to get a 12 lead ecg? It appears that he was ready to go to 200 joules based on the monitor. Sorry if I sound critical. Maybe I'm missing something. Regardless, you always put out a new and interesting topic with your videos. Well done!

[@lmellick]

The nurse was right on here. The attending seemed to not think 100 joules would work. And, he briefly made the mistake of trying to rely on the monitor for this slow atrial fibrillation. My videos are real life, and in real life the nurses play a huge roll in reminding and prompting us and this is just an example of that.

[@macmedic892]

Larry Mellick “Doctors save lives, nurses save doctors”

[@stephdyan]

I've had one episode of PSVT and got adenosine in the ambulance. That hurt like an SOB but I corrected pretty quickly. I can't imagine getting cardioversion although I didn't get any sedative. This is such a great prospective since the pt is a doctor

[@mirani18]

great .. did one the other day but this one was an elite patient!

[@jimmyg197]

Thanks, I've had 3 of them but never saw what went it to getting set up or what it looked like while going thru it now I know.....

[@ericgudjohnsen8870]

If you have PSVT and when converted pause for long periods of time coughing or High G straining can keep your world from going black. This video is great I hope it make people feel better about being treated and about treating people better and faster.

[@Javelinfanatic]

Excellent video! I wish more ER doctors would follow the actual appropriate algorithm's as opposed to always just giving cardizem and not actually fixing the rhythm.

[@Cdominguez003able]

amazing video. It helping me out to understand cardioversion as a nurse and the same time gave some tips to share with my patients. thanks Dr.

[@lou-nc4rc]

Thank you so much for this video. I just had my second cardioversion in 6 years and wondered what it looked like while I was knocked out. When they do those rescues of people outside of hospitals, not for a fib, it looks like a big scary jolt of electricity. But this was not. Just a small bounce. I had to have the TEE first, which this doctor skipped.

[@lmellick]

You are welcome!!

[@nikhil0madala]

Dr Bruce is a LEGEND :D

[@lmellick]

Absolutely!

[@Sara5698]

I love those who have a passion to teach

[@segovian]

At 10:13, the physician had a saline flush with no cap just inside his pocket? Seems like an unnecessary infection risk, especially coming from a physician.

[@joshuarios1031]

Good job to the dr or nurse suggesting an EKG strip while the doc was already setting up for 200 shock.

[@novu16]

one of a kind video...simply awesome

[@lmellick]

Thank you!!

[@oxfd611]

Thank you Dr Janiak.

[@Fisherdave10]

Very cool! Thank you Dr. Janiak.

[@kirubakaran09stanley]

Your channel is really awesome sir ..

[@lmellick]

Thank you, Kiruba!

[@austinhall7818]

That's Doctor to you

[@brucetomaszewski7691]

Excellent case.

[@NathanPsprague]

34yr male. I have been cardioverted 4 times now due to intermittent afib that is trigger when playing basketball. It definitely is a scary process the first time around. Unfortunately I have become a professional at this. I have lost 30 pounds, discontinued playing basketball. I am just walking more to stay active. I miss playing basketball though. I have not had any afib episodes. My EP was considering a cardiac ablation, but my wife and I decided against it. Thanks for this video, I have always be curious about what goes on once those meds kick in.

[@lukeasselin3214]

I've been cardioverted last weekend.. and 3 years ago. I'm turning 34 next week and I've been considering the ablation as well. I might go instead with the "pill in a pocket" treatment... I'm watching this video for the exact same reason as you.. was curious to see what It looked like when med kicked in haha!! Our stories look alike Nathan.. but my afib both time started while I wasnt doing anything.

[@NathanPsprague]

Yes our story sounds very similar. Sorry to hear your going through that same thing. Ya I have my pill in the pocket also. Although the meds have never put me back in normal rhythm, only the cardiovert. I hope everything gets better for you!

[@lukeasselin3214]

@@NathanPsprague so what kind of rythm you get when taking your pill ?!

[@NathanPsprague]

Just the same aFib. It’s seems that the medication has little to no effect. Although when I do take the meds the cardiovert works better. The one time I didn’t take the meds and they tried a cardiovert, I was still in aFib. Everyone is different though so hopefully that approach works better for you!

[@NathanPsprague]

Just the same aFib. It’s seems that the medication has little to no effect. Although when I do take the meds the cardiovert works better. The one time I didn’t take the meds and they tried a cardiovert, I was still in aFib. Everyone is different though so hopefully that approach works better for you!

[@nng1979]

I got cardioverted at 27 after being in A-fib for about 10 hrs. The head tingling before you get knocked out is freaky

[@the7Ced]

Thank you so much for your excellent video, Dr. Mellick! One question: It appears to me that the doc at 10:13 stores is saline syringe (unprotected) in his pocket. Doesn't seem like a good place to me, does it?

[@jacoveybanks9663]

Great video!!

[@markjching]

Great video, thanks for sharing.

[@ronblair5476]

I saw he was diagnosed at 39. Was there any cause? I was diagnosed in my early 20s. I've never been electrically cardioverted. I have had a complex pulmonary vein isolation. Also had a small brain stem stroke (ischemic) most likely due to the a fib. Definitely a change being young and having this. He's a trooper for working through this! I haven't been as lucky. It's a horrible feeling

[@lmellick]

I don't know if there was any known cause. I'll have ask him about the details. Thanks for sharing your story.

[@tylersommerRMU]

Great video guys, thanks for sharing. I've shared it with my students in my PA Cardiology course. Thanks!

[@fullthrottle9086]

Im only 30 years old and i have an irregular rythem got this tommorrow hope it works as i hate being on apixaban

[@throe68]

Good luck!

[@fullthrottle9086]

It worked but still on the apixaban

[@scorpiistar]

great video ❤

[@franklinmbayaq7781]

Many thanks to Dr. Janiak and the awesome ER staff, I have a question, suppose the patient doesn't convert with the first attempt, what are the intervals for subsequent shocks and do we have a maximum number of attempts that cannot be exceeded? and if so, do we go back to Chemical cardioversion? Thanks again for this great video.

[@lmellick]

Generally there is no waiting period other than checking the patient and prepping for the next attempt. I'm not sure if there is any guidelines, but if the patient is stable maybe two or three attempts before I would begin to regroup and consider other options. There is some cardiology literature describing the use of double simultaneous or sequential cardioversion for treating resistant atrial fibrillation. www.ncbi.nlm.nih.gov/pubmed/15655268

[@athelmiller7798]

This has been extremely informative. Thank you for publishing this video!

[@brokenmedic9133]

Such an awesome Dr.

[@orenkrimchansky]

yo! thanks doc. great video as usual just one thing. propofol inhibiit / reduce ventilation, thats a fact. Apneic oxygenation will hold high saturation just for a while. you can see from 11:47 till the jaw thrust and beyond thet he is not ventilating or ventilating so shallow to use just the dead space my message is , to ventilate slowli and gently with a bag mask if patient desaturate. : )

[@lmellick]

I agree with your comments. Thanks.

[@hanovergreen4091]

Is 74. Treats patients while in atrial fib. I don't know if that's a feature or a bug, but seems to be one tough hombre.

[@ardenpowers7730]

Fantastic Video ! Thank you so much for sharing !!! :)

[@lmellick]

You are welcome!

[@hijeckgreg]

Awesome video

[@amels5957]

God bless you all.you are all great.thank you so much👌

[@ionhunter]

Dr. Mellick,Did he ever have a heart ablation before this? BTW: My buddy was born with an extra SA Node, discovered during his heart ablation. And he had zero of the risk factors for A Fib till one day his HR hit 150+ at rest.

[@lmellick]

No ablation.

[@bibisart4198]

Thank you so much for uploading the videos really helpful

[@tmccoy9858]

thanks again for the very educational video

[@lmellick]

You are welcome.

[@A-nom-a-ly]

i had this done at 35 at 4a.m in the morning. was having a terrible A Fib episode and needed it done. it was easy. i do remember the pain of the jolt, they had to do it 2 times on me. because of the higher voltage i did have vary minor burns where the pads where and it was like a sun burn for a few days. other then that i was home and in bed by 7a.m. after some monitoring.

[@lmellick]

Nice, thanks for sharing your experience!

[@icdumppl2024]

​@@lmellickwhy is sedation not used on everyone? I had it.

[@lmellick]

@@icdumppl2024 It is used for almost everyone with exceptions if the patient is "crashing" or too unstable for sedation medications.

[@nancymarieg]

i was cardioverted yesterday

[@nickawilliams5175]

ED gave me a 6mg dose of Adenosine when my HR was over 170.

[@susique333]

He hasn't eaten all day, any chance his electrolytes are a little wacky? (I'm a cardiomyopathy patient. I absolutely love these videos!)

[@lmellick]

Not that quickly, but thanks for the nice comments.

[@lou-nc4rc]

They did a preliminary blood test on me to check Mg and K.

[@chucketienne481]

Very good video. Thank you.

[@lmellick]

Thank you.

[@aimansalman2709]

This is amazing.

[@brwhitehead8378]

Thank you for sharing.