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.

Getting Ready

Before your procedure:

• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• You may need to take blood thinning medicine to stop clots from forming in your blood. Blood thinners also may help break down a clot in your atrium. You may need to take blood thinners for three to four weeks before, and after your procedure. Blood thinners make it easier for you to bleed or bruise. If you shave, use an electric shaver. Use a soft toothbrush to help keep your gums from bleeding.
  
  
• You may need to have blood tests done before your procedure. You also may need a transesophageal echocardiogram (TEE) to check for blood clots in your heart. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time and location of each test.

The night before your procedure:

• Ask caregivers about directions for eating and drinking.
  
  

The day of your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• Heart medicine may be used to help make your heart more sensitive to the electrical charge. This helps your heart change back to a normal beat during cardioversion.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.

Treatment

What will happen:

You will be taken to the room where the cardioversion will be done. You may be given anesthesia medicine to help you fall, and stay asleep during the 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. The electric shock is then given through the catheters.

After your cardioversion:

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.

Contact a caregiver if

• You cannot make it to your procedure.
  
  
• You have a fever.

Seek Care Immediately if

• Call 911 or an ambulance if you have any signs of a heart attack:
  
  
  • Discomfort in the center of your chest that feels like squeezing, pressure, fullness, or pain, that lasts for more than a few minutes or keeps returning
    
    
  • Discomfort or pain in your back, neck, jaw, stomach, or one or both of your arms
    
    
  • Feeling sick to your stomach
    
    
  • Having trouble breathing
    
    
  • A sudden cold sweat, particularly in combination with chest discomfort or trouble breathing
    
    
  • Feeling very lightheaded or dizzy, particularly in combination with chest discomfort or trouble breathing
  
  
• You have signs of a stroke: The following signs are an emergency. Call 911 immediately if you have any of the following:
  
  
  • Weakness or numbness in your arm, leg, or face (may be on only one side of your body)
    
    
  • Confusion and problems speaking or understanding speech
    
    
  • A very bad headache that may feel like the worst headache of your life
    
    
  • Not being able to see out of one or both of your eyes
    
    
  • Feeling too dizzy to stand

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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 (Precare)