Electrical & Chemical Cardioversion
What is Cardioversion?
Electrical Cardioversion is a brief procedure where an electrical shock is delivered to the heart to convert an abnormal heart rhythm back to a normal rhythm. Most elective or "non-emergency" cardioversions are performed to treat atrial fibrillation or atrial flutter, benign heart rhythm disturbances originating in the upper chambers (atria) of the heart. Cardioversion is used in emergency situations to correct a rapid abnormal rhythm associated with faintness, low blood pressure, chest pain, difficulty breathing, or loss of consciousness.
What is cardioversion for?
In patients with atrial fibrillation the atria in their heart fibrillate (or "quiver") due to chaotic electrical signals that circulate throughout both atria. This typically results in a fast and irregular heartbeat. While some patients have no symptoms, others may experience shortness of breath, lightheadedness and fatigue. Depending on your specific medical history and symptoms, your physician may recommend a cardioversion to return your heart to a normal rhythm.
What are the different types of cardioversion?
Cardioversion can be "chemical" as well as "electrical". Chemical cardioversion refers to the use of antiarrhythmia medications to restore the heart's normal rhythm. Antiarrhythmia medications work by modifying the heart's electrical properties to reduce the frequency of abnormal heart rhythms and to help restore a normal rhythm.
Electrical cardioversion (also known as "direct-current" or DC cardioversion) is a procedure whereby a synchronized (perfectly timed) electrical shock is delivered through the chest wall to the heart through special electrodes or paddles that are applied to the skin of the chest and back. The goal of the electrical cardioversion is to disrupt the abnormal electrical circuit(s) in the heart and to restore a normal heart beat.
What can I expect during the electrical cardioversion procedure?
An electrical cardioversion is performed in an Electrophysiology Laboratory. A cardiologist, a nurse and/or an anesthesiologist are present to monitor your breathing, blood pressure and heart rhythm.
Special cardioversion pads are placed on your chest and back (or alternatively, both pads can be placed on the front of the chest). The pads are connected to an external defibrillator by a cable. The defibrillator allows the medical team to continuously monitor your heart rhythm and to deliver the electrical shock to restore your heart's rhythm back to normal.
Since the shock can be painful, an anesthesiologist or specially trained nurse administers intravenous sedation. Cardioversion patients typically awake quickly without any recollection of the shocks, due to the amnesic effects of the sedatives.
How should I prepare for cardioversion?
- You should have nothing to eat or drink for at least eight hours prior to cardioversion procedure.
- Take your regularly scheduled medications the morning of the procedure unless your medical practitioner has told you otherwise. Your medications should only be taken with enough water to get the tablets down. If you are diabetic, you should discuss your insulin or other diabetes medication dosing with your medical practitioner.
- Bring a list of all your medications with you.
- Do not apply any lotions or ointments to your chest or back as this may interfere with the adhesiveness of the shocking pads.
- Most medical centers will not let you drive yourself home after receiving sedation/anesthesia; therefore you should arrange a ride home that day.
- For the remainder of the day, you should not operate a car, heavy machinery, or make any important decisions.
- You may experience some minor chest discomfort and/or skin irritation following the procedure. An ointment can be applied to the area to reduce the discomfort.
If you are having a cardioversion procedure you will be contacted prior to the procedure by a member of the team who will give you detailed instructions on how to prepare.
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