What is cardioversion?
Cardioversion is a procedure that sends an electrical shock (energy) to your heart muscle to correct an irregular or fast heart rhythm (arrhythmia).
Cardioversion can be used to correct many types of fast or irregular heart rhythms. The most common of these are atrial fibrillation and atrial flutter. Cardioversion is also used to correct ventricular tachycardia, which is a very fast, life-threatening heart rhythm that starts in the lower chambers of the heart (ventricles).
Why do I need cardioversion?
You may need a cardioversion to get your heart rate and rhythm back to normal so your heart can pump like it should. Abnormal heart rhythms can cause:
- A pounding or fluttering feeling in your chest.
- Shortness of breath.
- Chest discomfort.
- Dizziness or extreme fatigue.
These symptoms are signs that your heart is not pumping enough blood to your body. Even if you barely notice your symptoms, without treatment, you could have more serious problems, like a heart attack or stroke.
Before the Procedure
You will get detailed instructions before your cardioversion, but here are answers to some common questions.
Please make plans to have someone come with you to drive you home. You will not be able to drive for 24 hours after the procedure.
Should I take my medications?
Blood thinners and diabetes medications
Please ask your doctor how you should take your blood thinners/anticoagulants, such as Coumadin (warfarin), and your diabetes medications or insulin on the day of your cardioversion.
Unless your doctor or nurse tells you otherwise, take all other regular medications as scheduled. Please take your medications with small sips of water on the day of your cardioversion.
Can I eat before the procedure?
Eat a normal meal the evening before your procedure. DO NOT eat, drink or chew anything after 12 midnight before your procedure. This includes gum, mints, water, etc.
Be careful not to swallow any water when you brush your teeth.
What should I wear?
- Wear comfortable, easy-to-fold clothes when you come to the hospital. You will wear a hospital gown for the procedure.
- Do not wear makeup, nail polish.
- Do not use deodorant, powder, cream or lotion on your back or chest. These products can cause problems with the adhesive pads that are used during the procedure.
- Please leave all jewelry (including wedding rings), watches and valuables at home.
What should I bring?
Bring a complete list of your medications and a 1-day supply of your prescription medications. Do not take these medications without first talking with your doctor or nurse.
In the Procedure Room
The cardioversion will likely be done in the electrophysiology (EP) lab.
You will lie on a bed, and your nurse will start an intravenous (IV) line in your arm or hand. The IV is used to give you medications and fluids during the procedure.
EKG patches and adhesive cardioversion pads will be placed on your chest, and possibly your back. Men may have their chest hair shaved, if needed.
You may need to have a transesophageal echocardiogram (TEE) before your cardioversion. A thin tube with a transducer goes into your throat after it is numbed. The transducer creates pictures of your heart.
Will I be awake during the procedure?
No. You will get medication through your IV to make you fall asleep during the procedure.
What happens during the procedure?
While you are asleep, the doctor will use the cardioverter machine (defibrillator) to quickly deliver specific amounts of energy to your heart through the cardioversion patches. The shock interrupts the abnormal electrical rhythm and restores a normal heart rhythm. It may take several shocks to get the rhythm back to normal.
Monitors used during the procedure
Cardioverter: Attached to one sticky patch placed on the center of your back and one on your chest. This lets your healthcare team control your heart rate and deliver energy to your heart muscle.
ECG/EKG: Keeps track of your heart’s electrical activity. Several sticky patches (electrodes) are attached to your chest, and wires carry the information to a machine that creates a graph.
Blood pressure monitor: A cuff on your arm will inflate and deflate to keep track of the pressure inside your blood vessels.
Oximeter: A small clip on your finger measures the amount of oxygen in your blood.
How long does the cardioversion procedure last?
The procedure itself lasts only a few minutes. But, please plan to stay at Cleveland Clinic 4 to 6 hours for your appointment. The extra time is needed for procedure preparation and your recovery.
After the Procedure
Will I have to stay in the hospital?
You will likely go home the day of the procedure.
What should I expect during the recovery?
You will slowly wake up after the procedure. Once you are fully awake, the doctor will talk to you about the procedure results and your plan of care. Be sure to ask your doctor if you need to take the same medications you took before the procedure.
When you move to the recovery area, you can have something to eat and drink, and your family can visit. You may have an EKG before you go home.
How will I feel?
You will be drowsy from the medication used during the procedure. Your chest may be tender for a few days. We will give you hydrocortisone cream, if needed.
Your doctor will tell you which over-the-counter medications you can take for pain relief, if needed. Let your doctor or nurse know about any symptoms that are severe or last a long time.
Will I be able to drive myself home?
No. For your safety, a responsible adult must drive you home. You will not be able to drive for 24 hours after the procedure.
Managing your condition
Cardioversion is only one part of your plan of care. It is also important for you to take your medications, follow a heart-healthy lifestyle and keep your follow-up appointments. Please talk to your doctor if you have any questions or concerns.
