Cardioversion

Cardioversion

A cardioversion is a procedure used to restore a normal heart rhythm in people with certain types of abnormal heart rhythms, most commonly atrial fibrillation (AF), or atrial flutter.

What Is It?

A cardioversion involves delivering a controlled electric shock to the heart through the chest wall. This shock interrupts the abnormal electrical activity in the heart and allows the heart’s natural pacemaker cells to re-establish a normal rhythm.

What Happens Before the Procedure?

  • Fasting: You must fast for at least six hours before the procedure. Water may be allowed up to two hours prior.
  • Medication Review: Your cardiologist will advise you on which medications to continue or stop before the procedure. It is mandatory to stay on your blood thinners for a cardioversion.
  • Transport: Arrange for a family member or friend to take you home, as you will not be able to drive afterward 

Why Is It Done?

If you have atrial fibrillation, your heart may beat irregularly and too fast, which can cause symptoms such as:

  • Shortness of breath
  • Fatigue
  • Dizziness
  • Palpitations

Cardioversion is often recommended when medications have not been effective in restoring normal rhythm or when a rapid return to normal rhythm is needed. 

What Happens During the Procedure?

  • You will be given a short-acting anaesthetic to ensure you are asleep and do not feel the shock.
  • Electrode pads will be placed on your chest (and sometimes back).
  • A controlled electric shock is delivered through the pads to reset your heart rhythm.
  • The procedure typically takes less than 30 minutes, and you will be monitored throughout by a team including your cardiologist, nurse, and anaesthetist. 

After the Procedure

  • You will wake up quickly and will not remember the shock.
  • You may feel mild chest discomfort or skin irritation from the pads.
  • Most patients can go home within two hours.
  • You will be advised about medications prior to discharge.
  • Avoid driving or returning to work for the rest of the day.
  • Cardioversion is successful in restoring normal rhythm in most cases.
  • However, it does not prevent AF from returning, and some patients may require repeat procedures or additional treatments.
  • It is safe, with a minimal risk of complications when properly prepared.

Common Risks

  • Skin irritation or redness: This can result from the adhesive electrode pads used during the procedure.
  • Recurrence of atrial fibrillation (AF): AF may return within 12 to 24 months after a successful cardioversion.
  • Unsuccessful cardioversion: In some cases, the abnormal heart rhythm may persist despite the procedure.

Rare Risks

• Need for a pacemaker: This may be necessary if an underlying heart condition causes persistent rhythm issues.
• Blood clots: Cardioversion can dislodge existing clots in the heart, potentially leading to stroke.
• Heart attack: Though very rare, this is a potential complication.
• Death: While extremely rare, death is a possible risk associated with the procedure.