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Cardioversions

What is a cardioversion procedure?

A cardioversion is a procedure done at Piedmont Healthcare to help correct an irregular heart rhythm (arrhythmia). A physician will first review your medications and heart rhythm test results. 

You will be sedated, and when you are completely asleep, the physician will administer a very brief current of electricity. This electrical stimulation is intended to stop and replace the irregular heartbeat with a normal heart rhythm. This is called converting the rhythm. 

The physician will administer the electrical current one to three times. Most people will only receive one shock. If you do not convert after three attempts, the physician will not attempt any further electrical stimulation. The entire process lasts only a few minutes.

The sedative medication will take 10 minutes to two hours to wear off, depending on the medication used and your response. You will be asked to have someone drive you home, and you should plan to rest after the procedure. 

Your chest may be red after the procedure. You may apply lotion to any reddened areas. The nurse will keep you in the room until you are completely awake and able to sit up and talk. The nurse will make any follow-up appointments at this time and review any medication changes with you and your family members. 

Frequently Asked Questions

What is atrial fibrillation?

Atrial fibrillation is an irregular heartbeat that causes the heart's top chambers (the atria) to beat very irregularly and ineffectively. This causes several effects. First, the heart may have palpitations that cause the bottom, larger chambers (ventricles) to beat very rapidly in response to the atria. The rapid rate prevents the ventricles from having time to fill adequately with blood. This may cause dizziness or weakness. Secondly, if the atria are not contracting normally, blood does not empty completely, and this reduction in blood flow increases the risk of a blood clot forming in the heart's atria.

Why does my doctor want to cardiovert me? Why can't I just stay in atrial fibrillation?

The physician wants to cardiovert you because atrial fibrillation presents several risks for patients. First, many people have fatigue or shortness of breath associated with this condition. Secondly, there is a risk of rapid heartbeats due to stimulation of the ventricles by the irritable atria. Finally, the atria not contracting properly places you at a much higher risk of developing a clot in this heart chamber. The clot could dislodge at any time, and the blood clot may travel to another part of the body, causing a clot in the lung (pulmonary embolism) or the brain (stroke).

What are the risks involved with this procedure?

The most common risk is irregular heartbeats secondary to the delivery of the electrical stimulation of the heart. Typically, the heartbeat will be slow for one to two seconds after the shock is delivered and rapidly resume to a normal rhythm. The other risks include the possibility of a stroke if a blood clot is dislodged during the procedure. The physician may place you on blood thinners or use a special test called TEE to look for clots before performing the procedure. This is why your blood tests must reflect that you are adequately anticoagulated (thinned) before the procedure is done.

The risks associated with a TEE (transesophageal echocardiogram) include damage or irritation to the esophagus. The nurse will ensure you can swallow liquids before you are discharged.

How long will the cardioversion last?

There is no specific way to tell. It depends on several factors, including how long you were in atrial fibrillation, the condition of your heart and your overall medical condition.

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