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An arrhythmia​ is a disturbance in the normal rate or rhythm of your heartbeat. This is caused by abnormalities in the heart's electrical system and range from palpitations​ to life-threatening sudden cardiac death risks. The Heart Hospital Baylor provides advanced arrhythmia diagnosis, treatment, and management approaches to fit your needs in advanced facilities with a five-star patient experience.

Doctors use several procedures to restore a normal heart rhythm. One of these procedures is called cardioversion.

What is Cardioversion?

Cardioversion is a procedure that can restore fast or irregular heartbeat to a normal rhythm. Cardioversion is done two ways: using an electrical procedure or using medicines.

For the electrical procedure, your heart is given low-energy shocks to trigger a normal rhythm. You're temporarily put to sleep before the shocks are given. This type of cardioversion is done in a hospital as an outpatient procedure. "Outpatient" means you can go home after the procedure is done.

Using medicines to correct arrhythmias also is a form of cardioversion. This type of cardioversion usually is done in a hospital, but it also can be done at home or in a doctor's office.

This article only discusses the electrical cardioversion procedure.

Cardioversion isn't the same as defibrillation, although they both involve shocking the heart. Defibrillation gives high-energy shocks to the heart to treat very irregular and severe arrhythmias. It's used to restore normal heartbeats during life-threatening events, such as sudden cardiac arrest​.

Who Needs Cardioversion?

Your doctor may recommend cardioversion if you have an arrhythmia that's causing troublesome symptoms. These symptoms may include dizziness, shortness of breath, extreme fatigue (tiredness), and chest discomfort.

Atrial fibrillation​, or AFib, is a common type of arrhythmia treated with cardioversion. In AFib, the heart's electrical signals travel through the heart's upper chambers (the atria) in a fast and disorganized way. This causes the atria to quiver instead of contract.

Atrial flutter, which is similar to AFib, also might be treated with cardioversion. In atrial flutter, the heart's electrical signals travel through the atria in a fast, but regular rhythm.

Cardioversion sometimes is used to treat rapid heart rhythms in the lower heart chambers (the ventricles).

Cardioversion usually is a scheduled procedure. However, you may need an emergency cardioversion if your symptoms are severe.

For some people who have other heart conditions in addition to arrhythmias, cardioversion might not be the best treatment option. Talk with your doctor about whether cardioversion is an option for you.

What Should I Expect Before Cardioversion?

You usually can't have any food or drinks for about 12 hours before having cardioversion (as your doctor advises).

You're at higher risk for dangerous blood clots during and after a cardioversion. The procedure can dislodge blood clots that have formed as the result of an arrhythmia.

Your doctor may prescribe anticlotting medicine to prevent dangerous clots. They may recommend that you take this medicine for several weeks before and after the cardioversion procedure.

To find out whether you need anticlotting medicine, you might have transesophageal echocardiography (TEE) before the cardioversion. TEE is a special type of ultrasound. An ultrasound is a test that uses sound waves to look at the organs and structures in the body.

TEE involves a flexible tube with a device at its tip that sends sound waves. Your doctor will guide the tube down your throat and into your esophagus (the passage leading from your mouth to your stomach). You will be given medicine to make you sleep during the procedure.

The TEE will be done at the same time as the cardioversion or just before the procedure. If your doctor finds blood clots, they may delay your cardioversion for a few weeks. During this time, you'll take anticlotting medicine.

Even if no blood clots are found, your doctor may prescribe anticlotting medicine during and after the cardioversion to prevent dangerous blood clots from forming.

Before the cardioversion procedure, you'll be given medicine to make you sleep. This medicine can affect your awareness when you wake up. So, you will need to arrange for someone to drive you home after the procedure.

What Should I Expect During Cardioversion?

A nurse or technician will stick soft pads called electrodes on your chest and possibly on your back. They may need to shave some areas of your skin to get the pads to stick.

The electrodes will be attached to a cardioversion machine. The machine will record your heart's electrical activity and send low-energy shocks through the pads to restore a normal heart rhythm.

Your nurse will use a needle to insert an intravenous (IV) line into a vein in your arm. Through this line, you'll get medicine that will make you fall asleep.

While you're asleep, a cardiologist (heart specialist) will send one or more low-energy electrical shocks to your heart. You won't feel any pain from the shocks.

Your health care team will closely watch your heart rhythm and blood pressure​ during the procedure for any signs of complications.

Cardioversion takes just a few minutes. However, you'll likely be in the hospital for a few hours due to the prep time and monitoring after the procedure.

What Should I Expect After Cardioversion?

Your health care team will closely watch you after the procedure for any signs of complications. They will let you know when you can go home. You'll likely be able to go home the same day as the procedure.

You may feel drowsy for several hours after cardioversion because of the medicine used to make you sleep. You shouldn't drive or operate heavy machinery the day of the procedure.

You'll need to arrange for someone to drive you home from the hospital. Until the medicine wears off, it also may affect your awareness and ability to make decisions.

You may have some redness or soreness on your chest where the electrodes were placed. This may last for a few days after the procedure. You also may have slight bruising or soreness at the site where the IV line was inserted.

Your doctor will likely prescribe anticlotting medicine for several weeks after the procedure to prevent blood clots. During this time, you also may take medicine to prevent repeat arrhythmias.

What are the Risks of Cardioversion?

Although uncommon, cardioversion does have risks. The procedure can sometimes worsen arrhythmias. Rarely, it can cause life-threatening arrhythmias. These irregular heartbeats are treated with electrical shocks or medicines.

Cardioversion can dislodge blood clots in the heart. These clots can travel to organs and tissues in the body and cause a stroke​ or other problems. Taking anticlotting medicines before and after cardioversion can reduce this risk.

Source: National Heart, Lung, and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services.

Why The Heart Hospital?​​

Advanced technology meets compassionate care at Baylor Scott & White The Heart Hospital – Plano. Providing innovative treatment methods for cardiac arrhythmias to our guests is an important part of The Heart Hospital's patient experience. Experiencing a heart arrhythmia​ can certainly be life-changing. But, thanks to procedures like cardioversion, it doesn't have to keep you from living your best life. For more information on arrhythmias and The Heart Hospital, visit our resources »

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