Cardioversions

Electrical cardioversion is a procedure in which an electric current is used to reset the heart's rhythm back to its regular pattern (normal sinus rhythm). Pads are applied to the chest wall and through these pads, low-voltage electric current is applied to “convert” your rhythm.  Generally a cardioversion is used for patients in atrial fibrillation or atrial flutter.

How does it get set up?

When your doctor decides with you that you need to have a cardioversion, a time is scheduled at the hospital for the procedure.  Our office schedulers will arrange a time at the hospital that is convenient for you.  To decrease the chance of developing a stroke from the cardioversion, your doctor will have made certain that you have had your blood adequately “thinned” with coumadin consistently for 3-4 weeks prior to the procedure, combine the cardioversion with a transesophageal echocardiogram (please set link here) that will check for a blood clot in your heart chamber, or be pretty certain that you have only been in the abnormal rhythm for less than 24-48 hours.

How to prepare for the cardioversion?

We ask that you consume nothing by mouth (NPO) after midnight prior to the procedure other than prescribed medication with a small quantity of water.  Diabetic patients:  If on insulin: Take ½ dose of prescribed dose night before and morning of the test. If taking oral (by mouth) diabetic medications: No oral diabetic medications on the day of the procedure.  After two hours after the completion of the procedure, you will be able to eat and drink, and at that point diabetic patients can return to normal doses of your diabetic medications.  We ask that you come with someone that can drive you home or least that you have a way of getting home without driving yourself home because of the effect of sedative medication that you will receive.

What happens at the procedure?

When you arrive at the hospital on the day of the cardioversion, you will be registered and taken to a procedure room.  You will be greeted by a nurse who will review your medical history and prepare you for the procedure.  A hospital gown top will be given to you for you to change into.  EKG electrodes will be placed on your chest so your rhythm can be followed.  Cardioversion pads that eventually will deliver the electrical energy will be placed on your chest and back. You will have your oxygen level and blood pressure followed.  You will meet an anesthesiologist who will review your medical history and be present during the procedure to administer medication that will make you unconscious so you will not feel or be aware during the cardioversion.  Once you are unconscious (asleep), the cardiologist will attempt to “cardiovert” you.  Hopefully successful, you will shortly awaken and be observed until you have recovered and can be safely discharged home.

How well does it work?

The success of electrical cardioversion depends on how long you have had atrial fibrillation. Cardioversion is less successful if you have had atrial fibrillation for longer than 1 year.  Electrical cardioversion is an effective treatment for recent-onset atrial fibrillation. About 86% of people who receive cardioversion return to normal sinus rhythm immediately after the procedure. This success rate increases to 94% when antiarrhythmic medications are given before cardioversion.