Treatment Options

Cardioversion

If drugs are not able to control a persistent irregular heart rhythm (such as atrial fibrillation), cardioversion may be required. Electrical cardioversion is a process by which the heart is shocked to convert it from an irregular rhythm back into a normal sinus rhythm.

For patients in persistent atrial fibrillation, electrical cardioversion may be done early in the process to stop the afib and put the heart back into normal sinus rhythm. For other afib patients, electrical cardioversion may not be tried until later, when medication has stopped working. While electrical cardioversion may be effective at converting the heart back into normal sinus rhythm, it has a low success rate in keeping it there, and thus may require multiple tries. It also doesn't cure afib.

What should you expect if you are going to have a cardioversion?

First, to avoid having blood clots break free during this procedure, you may take anticoagulants for one to two months before the procedure to eliminate your risk of blood clots. If you can't take anticoagulants, you may have a transesophogeal echocardiogram (TEE) in which you swallow a narrow tube with a camera that makes ultrasound images of the heart to ensure that your heart doesn't contain any blood clots.

Dr Smith will tell you not to have anything by mouth after midnight the night before the procedure.

You will have your electrical cardioversion in the electrophysiology (EP) lab or suite. Once you arrive, an IV will be inserted for receiving medications and fluids and connected to monitors so the doctor can see what is happening. When it's time for the procedure to begin, you'll be given a medication intravenously to put you to sleep.

Once you're asleep, Dr Smith will use the defibrillator/cardioverter/pacemaker machine to give your heart a jolt of energy that will be delivered through paddles or EKG-type patches placed on the front and back of the chest. This electric shock should restore your normal heart rhythm, and may take several tries. This is different from defibrillation done in emergent situations, in which a more powerful shock is used to resuscitate a patient.

Following cardioversion, medications may be adjusted to maintain normal rhythm.