Cardioversion

Overview

Cardioversion is a heart procedure performed to restore the normal heart rhythm in people experiencing irregular heart rhythms.  

Your cardiologist will send an electric shock to your heart to restore your normal heart rhythm during cardioversion. 

Cardioversion is typically performed in the hospital, and most people go home the same day as the procedure. In some cases, it is performed as an emergency procedure. 

Your doctor will know immediately if the procedure restored a normal heart rhythm.

Candidates for cardioversion

Your doctor may recommend cardioversion if you have been recently diagnosed with atrial flutter or atrial fibrillation, and your doctor wants to intervene early to restore normal heart rhythm. 

Cardioversion may also be performed later in the process if medications have not helped alleviate your symptoms, such as shortness of breath, dizziness, and palpitations.

Evaluation criteria for cardioversion include:

• The upper chambers of your heart are not enlarged
• Your heart function, circulation, and blood vessels are stable

If you have any of the following conditions or complications, you may not be a good candidate for cardioversion:

• You have an arrhythmia due to drug toxicity
• You have a blood clot that has traveled to your heart
• You are not able to take anticoagulant medicines to be able to have a transesophageal echocardiogram
• You have another co-existing severe illness or infection

Preparing for cardioversion

While cardioversion is generally a scheduled procedure, some patients may need to have cardioversion as an emergency procedure.

In preparation for cardioversion, you will be asked to avoid eating or drinking anything for eight hours before the procedure. If you take regular medications, inform your doctor, and inquire if you should take these medications before the procedure. If you are allowed to take the medications, only take a sip of water with the medication.

Your doctor may order a transesophageal echocardiogram procedure to determine if you have blood clots in your heart. If a blood clot breaks free during cardioversion, it can cause fatal complications.

If a blood clot is found during the transesophageal echocardiogram, cardioversion will be delayed. You will be required to take blood-thinning medications. Your doctor will determine when you are safer for cardioversion.

What to expect during cardioversion

Cardioversion is performed in a hospital under general anesthesia. A cardiologist will perform the procedure. You will generally go home the day of the procedure. 

A care team will place electrodes on your chest that are connected to a cardioversion machine using wires. The cardioversion machine will monitor your heart rhythm and send electric shocks to the heart to restore your heart rhythm. If your heart beats too slowly after cardioversion, the cardioversion machine will correct your heart rhythm.

Recovery from cardioversion

After the procedure, you will be moved to a recovery area. As you slowly wake up from the sedation, you will be monitored for any complications. If the procedure and recovery went smoothly, you will likely be able to go home that day.

You will need to have someone with you to drive you home as the effects of sedation wear off.

After cardioversion, most people experience immediate symptom relief. Work closely with your doctor to determine when it is safe to return to your normal activities. 

You will likely need blood-thinning medications after the procedure to ensure clots do not form.

Your doctor will likely recommend lifestyle changes to improve your health after cardioversion. It is essential to schedule regular follow-up visits for ongoing monitoring,