What is it?
Cardioversion is a procedure used to restore a heart with an abnormal rhythm using low energy shock waves (electric cardioversion) or medication (chemical or pharmacological cardioversion). This procedure may be used on people who have conditions such as atrial fibrillation or atrial flutter. The goal is to synchronize the heart’s rhythm back into a normal pattern. It is most commonly scheduled in advance but can be used in an emergency situation. Cardioversion is different than a defibrillation – cardioversion uses lighter shocks than defibrillation and defib is used to stop severe rhythms that lead to sudden death.
Why you might need it:
If your heart beats too fast (tachycardia) or irregularly (arrythmia), like with atrial fibrillation (A-fib) or atrial flutter conditions, your doctor may recommend cardioversion. An irregular heartbeat may increase your risk of stroke or life threatening rhythms that lead to sudden death. It may be recommended if you’re regularly experiencing heart palpitations, shortness of breath, dizziness or chest discomfort as a result of an irregular heart rhythm. If your symptoms are minor, or you are elderly, cardioversion may not be recommended for you. Your healthcare provider may recommend other methods for slowing or regulating your heartbeat before trying cardioversion.
Risks:
Cardioversion is considered safe, although there are some risks associated with the procedure. Blood clots can be dislodged as a results of shocking the heart, which could lead to stroke or pulmonary embolism. Your healthcare provider may check for blood clots prior to the procedure and/or prescribe blood thinners to minimize this risk. Irregular heart rhythms may return or occur following the procedure. If you are having an electric cardioversion, you may experience burns where the paddles or pads are placed.
How to prepare:
Most of the time cardioversions are a preplanned, scheduled procedure. In these instances, your healthcare provider will provide you with specific instructions prior to your procedure to help you prepare. You should always follow your doctor’s instructions prior to a procedure and never do things such as discontinuing OTC or prescription medications without their guidance. Your doctor may recommend you start taking blood thinners prior to your procedure. If that is the case, they will give you a prescription and tell you when to start taking them. A transesophageal echocardiogram may be needed before your procedure to check for blood clots and determine the best course of action if they are found. Typically you will be asked to fast prior to your procedure. Your healthcare provider will instruct you on how long to do so.
You should plan to wear comfortable clothing and arrange for someone to accompany you, as you will be groggy from anesthesia and will not be able to drive.
What to expect/results:
When you arrive for your procedure, you will be asked to wear a hospital gown so they can attach the paddles or electrodes to your chest. You will receive an IV through which sedatives and anesthesia will be administered. Whether you are having an electrical cardioversion or chemical cardioversion will determine what happens next.
Electrical cardioversion: During an electrical cardioversion, will record your heart rhythm using the paddles or patches attached to your chest and administer low-energy electrical shocks in an attempt to reset your heart rhythm. Typically this only takes a few minutes. Your healthcare team will closely monitor you and your vitals to ensure there are no complications with the procedure. You will then be taken to a recovery room where they will continue to closely monitor you as you wake up from anesthesia.
Chemical or pharmacological cardioversion: During a chemical cardioversion, you will be given medication through your IV to help restore your heart’s normal rhythm. Once complete, you’ll be taken to recovery.
Typically results are immediate, although you may need several cardioversion procedures before your heart’s natural rhythm is restored. You should follow a heart-healthy lifestyle to help maintain your health.