Cardioversion Procedure
Overview
Cardioversion is a common tool in cardiology for restoring a normal heart rhythm when it becomes irregular. Doctors use brief, low-energy electrical shocks or certain medications to help fix arrhythmias, such as atrial fibrillation.
Most cardioversion procedures are planned in advance, but doctors can also perform them if an urgent situation occurs. This treatment differs from defibrillation, which treats life-threatening heart problems.
Purpose of the Procedure
Doctors use cardioversion to treat heart rhythm problems, such as arrhythmias. They often recommend it when the heart beats too fast or out of order. This procedure helps people with conditions like atrial fibrillation, atrial flutter, supraventricular tachycardia (SVT), and sometimes ventricular tachycardia.
| Condition | Why Cardioversion May Be Used |
|---|---|
| Atrial Fibrillation (AFib) | To restore a regular heart rhythm. |
| Atrial Flutter | To slow down rapid heartbeats. |
| Supraventricular Tachycardia | To address rapid rhythms occurring in the atria. |
| Ventricular Tachycardia | To stop persistent fast heartbeats. |
Symptoms such as dizziness, chest discomfort, weakness, and shortness of breath may prompt doctors to recommend cardioversion.
Possible Issues and Complications
Cardioversion is generally safe, but there are a few possible risks—though most are uncommon. One main concern is blood clots, especially in people with irregular heart rhythms like atrial fibrillation.
If a blood clot has formed in the heart, the electric shock used in cardioversion might move it, possibly causing a stroke or a blockage in the lungs. To prevent this, doctors usually check for clots before the procedure and may prescribe blood thinners to reduce the risk.
Another possible issue is the development of abnormal heart rhythms shortly after the shock. These usually appear within minutes and can often be treated with medication or a second shock if needed.
Some people may get mild skin burns where the electrodes were placed, but this is rare. For pregnant patients, doctors carefully monitor the baby’s heartbeat throughout the procedure to ensure both mother and baby remain safe.
Risks Table
| Risk | Description |
|---|---|
| Blood clots | May cause stroke or lung blockage. |
| Irregular heartbeats | New arrhythmias soon after treatment. |
| Skin burns | Mild burns on the chest caused by sensor use. |
How You Get Ready
Preparation for elective cardioversion often begins days to weeks before the procedure. Doctors may order an echocardiogram to check for blood clots in the heart. If clots are found, blood thinners are usually prescribed for 3–4 weeks.
Medication Checklist
Your physician will go over any medications you may need to take before cardioversion, including:
- Blood thinners
- Antiarrhythmic medicines
- Beta-blockers
- Calcium channel blockers
You’ll also receive instructions about which regular medications to take or pause, since some can affect heart rhythm or blood pressure.
Most people are asked not to eat or drink for about eight hours before the procedure. Your care team will explain what to expect on the day of cardioversion, including the use of a sedative to help you stay relaxed and comfortable.
What You Can Expect
What Happens During the Treatment
Doctors perform cardioversion in a hospital setting. A nurse or doctor places an intravenous (IV) line in the hand or arm to administer medications. The healthcare team typically provides a sedative to help patients feel relaxed.
If electrical cardioversion is used, staff attach large sticky pads with sensors to the chest or back. The sensors connect to a defibrillator that monitors heart rate and rhythm.
The doctor sends quick, controlled electrical shocks to the heart to correct the abnormal rhythm. This process usually takes a few minutes, and the team monitors it closely. For chemical cardioversion, the doctor gives medication through the IV to help restore a normal heart rhythm without an electrical shock.
Right After the Procedure
After the procedure, staff usually keep people in a recovery area for about an hour. They closely watch vital signs, including heart rate and heart rhythm, to make sure there are no immediate complications.
Before leaving, the healthcare team explains which symptoms to watch for at home and when to seek medical help. A responsible adult needs to drive the patient home, as the sedative can make them drowsy.
Doctors often prescribe blood-thinning medication (anticoagulants) for several weeks after cardioversion to help prevent blood clots, even if no clots were found beforehand.
Outcomes
Most people return to a normal heart rhythm soon after cardioversion. Some may need more than one treatment to achieve a steady rhythm.
Key points for better heart rhythm and recovery:
- Avoid smoking and tobacco.
- Follow a diet rich in fruits, vegetables, and whole grains.
- Limit salt, sugar, and unhealthy fats.
- Exercise regularly as advised.
- Maintain a healthy weight.
- Sleep 7–8 hours each night.
- Manage emotional stress.
| Lifestyle Change | Benefit |
|---|---|
| Healthy eating | Supports normal heart rhythm. |
| Regular activity | Aids recovery. |
| Stress management | Reduces risk of irregular rhythm. |
