Cardioversion

Atrial tachycardia rapid beating of the heart, originating in the atrium with rapid ventricular heart rate Ventricular tachycardiarapid beating of the heart, originating in the ventricleVentricular fibrillation rapid movement of the ventricular muscle without effective beats Risk Factors for Complications During the ProcedureBlood clots in the heart chambers that may be dislodged into the circulation during cardioversion What to Expect Prior to Procedure For elective cardioversion: To diagnose the condition, you will have an electrocardiogram (ECG, EKG)a test that records the heart's activity by measuring electrical currents through the heart muscle. You may be given blood thinners for several weeks prior to nonemergency cardioversion. You may undergo transesophageal echocardiogram to evaluate the presence of blood clots in the heart. Arrange for a ride to and from the procedure.Arrange for help at home after the procedure.The night before, eat a light meal and do not eat or drink anything after midnight.Do not take digoxin, a heart medication, the morning of the procedure.For urgent cardioversion, there is no time for to prepare for the procedure.

During the ProcedureYou will have continuous cardiac monitoring.An intravenous line will be placed to administer medications or fluids as needed.Short-acting, deep sedation or anesthesia will be given. Anesthesia Short-acting general or brief, deep sedation Description of the ProcedureElectrodes or paddles are applied to the chest. An electric charge is delivered through these electrodes or paddles to the chest and into the heart. This momentarily stops the electrical activity of the heart and allows the heart to reset itself into a normal rhythm. This may need to be repeated several times, with a gradually increasing electric charge. After ProcedureYou'll be monitored closely in a recovery room or in the coronary care unit of the hospital. If you had nonemergency cardioversion, you'll be sent home after the sedation wears off and once you are in stable condition. How Long Will It Take?The procedure itself is usually less than 30 minutes. You will need to be monitored for at least several hours after the procedure. Will It Hurt?Anesthesia prevents pain during the procedure. If you have urgent cardioversion, you may still be unaware of the pain involved, or you may feel a jolt that some people liken to a kick in the chest.

Possible ComplicationsInability to stop the abnormal rhythmResumption of the abnormal rhythm after a normal rhythm was establishedDevelopment of a more dangerous dysrhythmiaDamage to the heart muscle Blood clots introduced into your circulation, leading to such complications as stroke or damage to your intestines, kidneys, or limbs Burning or irritation to the skin of the chest where the paddles or electrodes are appliedDeath Average Hospital StayElective procedures are usually performed in a monitored outpatient setting, and most people can go home later that day. People who need emergency cardioversion may be admitted to the hospital for further observation or because of the illness that caused the event. Postoperative CareYou may be put on blood thinners for a few weeks after undergoing cardioversion. (In which case, blood levels of these medications will need to be monitored via blood tests, usually weekly). You may also be put on a medication called an anti-arrhythmic, which will help prevent the dysrhythmia from recurring. OutcomeCardioversion usually results in a more normal heart rhythm Call Your Doctor If Any of the Following OccursBlisters, redness, or open sores on your chestLightheadedness, dizzinessConfusionSensation of your heart fluttering (palpitations)Sensation of a skipped or missed beat, or an irregular pulseCough, difficulty breathing, shortness of breathSevere nausea or vomitingChest pain or pain in your left arm or jawPain in your abdomen, back, arms, or legsBlood in your urineChanges in vision or speechDifficulty walking or using your limbsDrooping facial muscles RESOURCES:

American Heart Associationhttp://www.americanheart.org National Heart, Lung, and Blood Institutehttp://www.nhlbi.nih.gov/index.htm CANADIAN RESOURCES: Health Canadahttp://www.hc-sc.gc.ca/index_e.html Heart and Stroke Foundation of Canadahttp://ww2.heartandstroke.ca/Page.asp?PageID=24 References: Procedures for Primary Care Physicians . Mosby-Year Book, Inc; 1994. Last reviewed November 2007 by J. Peter Oettgen, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.