Cardioversion
“Electrical cardioversion” is a cardiac procedure that shocks the heart to convert an irregular rhythm back into a normal sinus rhythm. Most often is used to convert Atrial Fibrillation or Atrial Flutter into normal rhythm.
How do you prepare for cardioversion?
• Fast (not eat or drink anything) for 6 hours before the procedure.If you take oral anti diabetic pills, skip the one before cardioversion. If you are on insulin, take only half the dose prior to cardioversion.
• Be compliant with anti-coagulation (blood thinners). If on Coumadin, your INR should be above 2.0 for 4 weeks consecutively; if on Eliquis, Xarelto or Pradaxa, we recommend no skipping dose for 4 weeks before cardioversion. Following strict anti-coagulation schedule prevents possible strokes triggered by small blood clots.• If 4 weeks of anti-coagulation cannot be confirmed, a TEE procedure, may be recommended prior to cardioversion, to exclude any blood clots in your heart. For TEE, please refer to” cardiac procedures – TEE.
How is cardioversion performed?
• A cardioversion is always performed in the hospital and takes less than 20 min. Most patients are discharged home after 3-4 hours, when relaxing medications are wearing off
• An IV access will be inserted into your arm
• Sticky pads will be put on your chest (men may need their chests shaved to help these stick)
• Your Heart rhythm, blood pressure and oxygen level will be monitored throughout the procedure.
• You’ll be given medication to make you sleep (you’ll be asleep for the whole procedure). You will not remember the procedure and won’t feel any discomfort
• After you’ve fallen asleep, one or more low-energy electric currents will be sent to your heart, restoring the normal rhythm.
What happens after cardioversion
• You will probably feel drowsy for a little while and may not remember the procedure. In less than 3-4 hours you’ll be able to go home. Somebody should drive you.
• Some patients have sensitive skin at the site where the sticky pads are placed for the cardioversion.
• Avoid driving or operating heavy machinery for 24 hours after your procedure
Continue taking the blood thinners for at least 4 weeks post cardioversion; see us within 4 weeks for further plan and treatment
Key points to remember
• Even if cardioversion works, you may still need to take anti-coagulation to prevent a stroke.
• Cardioversion may fail to convert your rhythm. This usually when atrial fibrillation is caused by another heart disease, such as heart failure, or when you have had atrial fibrillation for long time.
• Cardioversion may be successful but atrial fibrillation often comes back. The longer you have had atrial fibrillation, the more likely it is to come back after cardioversion.
• Cardioversion is not the first line of treatment in Atrial Fibrillation It is usually indicated if you have symptoms
• despite medications or if you develop heart failure due to Atrial Fibrillation.
• Refer to Atrial Fibrillation treatments for more details.