Electrical Cardioversion

Overview

What is cardioversion?

Cardioversion is a procedure that 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).

Electrical Cardioversion Treatment

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 symptoms including:

  • 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.

Procedure Details

Before the Procedure

Your healthcare team will provide you with detailed instructions before your cardioversion, but here are answers to some common questions at Cleveland Clinic.

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 or 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.

What happens before the procedure?

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

Electrical Cardioversion Monitoring

Cardioverter: Attached to restoreone sticky patch placed on the normalcenter of your back and one on your chest. This lets your healthcare team control your heart rhythmrate 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.

How long does the cardioversion procedure last?

The procedure itself lasts only a few minutes. However, the preparation and recovery time for the procedure may add a few hours to your appointment. Please plan to stay at Cleveland Clinic 4 to 6 hours for your appointment.

If you have an appointment with your physician on the same day of the procedure, please plan to spend the entire day at Cleveland Clinic.

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 talk to you about the procedure results and your plan of care. Be sure to ask your doctor if you should continue taking your 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.

Recovery and Outlook

Managing your Condition condition

Cardioversion is only one part of your plan of care. It is also important for you to take your medications, a heart-healthy lifestyle and keep your follow-up appointments. Please talk to your doctor if you have any questions or concerns.

Resources

Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.

Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart, Vascular & Thoracic Institute Outcomes.

Cleveland Clinic Heart, Vascular & Thoracic Institute Cardiologists and Surgeons

Choosing a doctor to treat your abnormal heart rhythm depends on where you are in your diagnosis and treatment. The following Heart, Vascular & Thoracic Institute Sections and Departments treat patients with Arrhythmias:

Section of Electrophysiology and Pacing: cardiology evaluation for medical management or electrophysiology procedures or devices - Call Cardiology Appointments at toll-free 800.223.2273, extension 4-6697 or request an appointment online.

Department of Thoracic and Cardiovascular Surgery: surgery evaluation for surgical treatment for atrial fibrillation, epicardial lead placement, and in some cases if necessary, lead and device implantation and removal. For more information, please contact us.

You may also use our MyConsult second opinion consultation using the Internet.

The Heart, Vascular & Thoracic Institute also has specialized centers to treat certain populations of patients:

For younger patients with abnormal heart rhythms:

See: About Us to learn more about the Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute.

Contact

If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart, Vascular & Thoracic Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

Becoming a Patient

Abnormal Heart Rhythm Conditions

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Surgical Outcomes

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Our outcomes speak for themselves. Please review our facts and figures and if you have any questions don't hesitate to ask.

Last reviewed by a Cleveland Clinic medical professional on 05/17/2019.

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