Having Electrical Cardioversion

Cardioversion is a procedure that is done to return your heartbeat to a normal rhythm. It’s done when the heart is beating very fast or irregularly. This is called an arrhythmia. During the procedure, an electric shock is sent to the heart to reset it to a normal rhythm. This is done with a small machine that sends electric shocks to electrode pads on your chest. 

Cardioversion is most often a scheduled procedure. But in some cases, it may be done as an emergency treatment. This is done if symptoms are severe. You will likely be given medicine to let you sleep through the procedure.

What to tell your healthcare provider

Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements, and any recreational drug use.

Tests before your procedure

You may need blood tests before the procedure. These make sure the procedure is safe for you. Blood tests can also help find causes for irregular heart rhythms, such as abnormal levels of electrolytes or thyroid hormones. A cardioversion may not work if you have conditions that cause abnormal test results.

You may also have a transesophageal echocardiography test before the procedure. This test is a special kind of heart ultrasound. A flexible ultrasound probe is put down your throat and into your esophagus. There, the probe is closer to your heart. It lets your healthcare provider see if you have any blood clots. Your cardioversion will be delayed if a clot is found.

Getting ready for your procedure

Talk with your healthcare provider about how to get ready for your procedure. Follow their instructions about what medicines to take before the procedure. This includes medicines that may prevent arrhythmias. Don’t stop taking any medicine unless your healthcare provider tells you to do so.

You might be at a higher risk for blood clots, so your healthcare provider may want you to take blood thinner medicine. You may take this medicine several weeks before and after the procedure.

Make sure to:

• Ask a responsible adult family member or friend to take you home from the hospital. You cannot drive yourself.

• Follow any instructions from your healthcare provider about not eating or drinking before your surgery.

• Remove any jewelry that goes around your neck or is on your chest.

• Follow all other instructions from your healthcare provider.

You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully. Ask questions if something is not clear.

On the day of your procedure

Ask your healthcare provider about the details of your procedure. The procedure takes only a few minutes. It may be different when done as an emergency treatment. In general, you can expect the following:

• The healthcare provider will stick soft electrode pads on your chest to record your heart rhythm. Larger electrode pads used to deliver the energy shock will be placed on the front and back of your chest. These areas of skin may need to be shaved if you have hair on your chest or back. This is to help the electrode pads stick.

• The healthcare provider will attach wires to the electrodes. The wires connect to a cardioversion machine.

• You will get medicine through a vein in your arm to help you relax and ease the discomfort associated with the procedure.

• The cardioversion machine sends an energy shock to your heart. This should convert your heart back to a normal rhythm.

• Your healthcare team will closely watch your heart rhythm and watch for changes.

After your procedure

After you wake up from the procedure, you’ll be closely watched for signs of problems for several hours. You will likely go home the same day. You may feel sleepy for several hours because of the sedation. Your healthcare team will make sure it's safe for you to eat and drink and stand before you are able to go home. You will need to have a family member or friend drive you home. Your chest may be red or sore for a few days.

You may need to take blood thinner medicine for several weeks after the procedure. Take this exactly as directed. You may also need to take medicine to prevent arrhythmias. Take all your medicines exactly as directed.

Follow-up care

Follow up with your healthcare provider, or as advised. 

When to call your healthcare provider

Call your healthcare provider right away if you have skipped heartbeats or a rapid heartbeat. Call 911 or get medical care right away at the nearest emergency department if you have any of these:

• Trouble breathing or chest pain

• Dizziness

• Fainting

• Uncontrolled bleeding while taking blood thinner medicines

• Trouble with speech, limb weakness, or loss of vision