Cardioversion

WHAT YOU SHOULD KNOW:

• Cardioversion is a procedure done when you have an abnormal heart rhythm (beat). Abnormal heartbeats are also called arrhythmias. Your heartbeat is controlled by your heart's own electrical system. Problems with your heart's electrical system may cause your heart to beat abnormally some, or all of the time. Your heart has four chambers called the atria and ventricles. The atria are at the top of your heart, and the ventricles are the bottom of your heart. Most arrhythmias that need cardioversion start in the atria, and cause your heart to beat very fast. With an abnormal heartbeat, your body may not get the blood and oxygen it needs.
  
  
• Arrhythmias may cause you to feel weak, dizzy, and have trouble breathing. You also may be at a greater risk for heart failure and stroke. Before your procedure, you may need medicines to thin your blood to prevent blood clots. You also may need tests to check for blood clots in your heart. During cardioversion, a shock of electricity is delivered to your heart to help it return to its normal rhythm. The shocks may be given through paddles or sticky pads placed on your chest or back. Shocks also may be given through a catheter (long, thin, bendable tube) placed into, or near your heart. You may need to be shocked more than once to help your heart return to its normal rhythm. With treatment, your heart rate and rhythm may return to normal, and your symptoms, such as dizziness may resolve. Having cardioversion done may even save your life.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• You may have an allergic response to the anesthesia medicine used during your procedure. The electric shock used may cause burns on your skin. If you have internal cardioversion, you may bleed or get an infection. If you have a blood clot in your heart, the procedure may cause the clot to travel out of your heart. If a blood clot travels to your lungs, you may have trouble breathing. Blood clots also may travel to your brain causing a stroke, and you may die. Even with cardioversion, your heart may not return to, or stay in a normal heart rhythm. You also may begin to have other arrhythmias that need treatment.
  
  
• Without treatment your arrhythmia and symptoms, such as chest pain and tightness, may get worse. Your heart may not be able to pump enough blood and oxygen to the rest of your body. You may have worsening weakness, dizziness, and trouble breathing. Arrhythmias that are left untreated can increase your risk of heart failure or a heart attack. Arrhythmias also increase your risk for blood clots forming in your heart, and you may have a stroke. Choosing not to treat your abnormal heart rhythm may also lead to death. Talk to your caregiver if you have questions or concerns about your condition or procedure.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Oxygen: You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose.
  
  
• Medicines:
  
  
  • Blood thinners: This medicine helps stop clots from forming in your blood. Blood thinners also may help break down a clot in your atrium. Blood thinners may be given before, during, and after your procedure.
    
    
  • Heart medicine: This medicine is used to help make your heart more sensitive to the electrical charge. This helps your heart change back to a normal beat during cardioversion.
    
    
  • Sedative: This medicine is given to help you stay calm and relaxed.
  
  
• Tests: You may need the following tests before your cardioversion:
  
  
  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
    
    
  • Transesophageal echocardiogram:
    
    
    • A transesophageal echocardiogram (TEE) is a type of ultrasound that shows pictures of the size and shape of your heart. It also looks at how your heart moves when it is beating. These pictures are seen on a TV-like screen. If you are unable to take blood thinners before your cardioversion you may need a TEE to check for clots.
      
      
    • You will be given medicine to relax you during a TEE. Caregivers put a tube in your mouth that is moved down into your esophagus (food pipe). The tube has a small ultrasound sensor on the end. Since your esophagus is right next to your heart, your caregiver can see your heart clearly.
  
  
• General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your procedure:

During cardioversion, your caregiver sends an electrical shock to your heart muscle. The shock is given at a certain time during your heartbeat that will best help it return to normal. You may need one of the following kinds of cardioversion:

• External: During external cardioversion, paddles or gel pads are used to shock your heart. Two pads will be placed on your chest, or one will be on your chest and one on your back. Your caregiver will watch your heartbeat on a monitor for the right time to deliver the shock. After the shock is given, your heartbeat will be checked. If your heart continues to beat abnormally, another shock will be given.
  
  
• Internal: During internal cardioversion, catheters (long, thin, bendable tubes) are put into your heart. Your caregiver inserts the catheters through a vein (blood vessel) and up into your heart. Fluoroscopy (special x-ray) may be used to check the catheter placement in your heart. The electric shock is then given through the catheters.

After your procedure:

You will be taken to a room where you can rest until you are fully awake. Do not get out of bed until your caregiver says it is okay. Caregivers will monitor your heart rhythm, and watch you closely for any problems. When caregivers see that you are not having any problems, you may be able to go home. If you are staying in the hospital, you will be taken back to your room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Copyright © 2011. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Cardioversion (Inpatient Care)