Cardioversion

What is Cardioversion?

Electrical cardioversion is a procedure that uses a controlled electric shock to restore your heart’s rhythm from an irregular rhythm, such as Atrial Fibrillation (AFib) or Atrial Flutter, back to a normal sinus rhythm.

How to Prepare for Cardioversion

• Fasting: Do not eat or drink for 6 hours before the procedure.
• Diabetes Medications:
  • If you take oral diabetes medications, skip your dose before cardioversion.
  • If you are on insulin, take half of your normal dose.
• Blood Thinners:
  • If you are on Coumadin (warfarin), your INR should be above 2.0 for 4 consecutive weeks before the procedure.
  • If you are on Eliquis, Xarelto, or Pradaxa, do not miss any doses in the 4 weeks leading up to cardioversion.
    
    

  Taking blood thinners as instructed helps prevent blood clots and strokes.
  
  

• Possible TEE Before Cardioversion: If you have not been on blood thinners for 4 weeks, your doctor may recommend a Transesophageal Echocardiogram (TEE) to check for blood clots in your heart before cardioversion.
  
  

How is Cardioversion Performed?

• Hospital Procedure: Cardioversion is done in a hospital and takes less than 20 minutes. Most patients can go home after 3-4 hours.
• IV Access and Monitoring:
  • An IV line will be inserted into your arm.
  • Sticky pads will be placed on your chest (men may need some chest hair shaved to help them stick).
  • Your heart rhythm, blood pressure, and oxygen levels will be monitored.
    
    
• Sedation: You will be given medication to help you sleep during the procedure. You won’t feel any discomfort or remember the procedure.
• Electric Shock: After you are asleep, low-energy electric currents will be delivered to your heart to restore normal rhythm.
  
  
  

After Cardioversion

• You may feel drowsy after the procedure and will need someone to drive you home.
• Some patients may have sensitive skin where the sticky pads were placed.
• Avoid driving or operating heavy machinery for 24 hours.
• Continue blood thinners for at least 4 weeks after the procedure and follow up with your doctor within 4 weeks.
  
  
  

Key Points to Remember

• You may need to continue taking blood thinners after cardioversion to prevent a stroke.
• Cardioversion may not always be successful, especially if you’ve had AFib for a long time or if it’s caused by another heart condition.
• Even if successful, AFib can return after cardioversion.
• Cardioversion is usually done if symptoms persist despite medications or if AFib causes heart failure.