Prior to Procedure

For elective cardioversion:

• To diagnose the condition, you will have an electrocardiogram [9] (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart [2] muscle [8].
• You may be given blood thinners for several weeks prior to nonemergency cardioversion.
• You may undergo transesophageal echocardiogram [10] to evaluate the presence of blood clots in the heart [2].
• 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 [2] medication, the morning of the procedure.

For urgent cardioversion, there is no time for to prepare for the procedure.

During the Procedure

• You 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 [11] or brief, deep sedation

Description of the Procedure

Electrodes or paddles are applied to the chest. An electric charge is delivered through these electrodes or paddles to the chest and into the heart [2]. This momentarily stops the electrical activity of the heart [2] and allows the heart [2] to reset itself into a normal rhythm. This may need to be repeated several times, with a gradually increasing electric charge.

After Procedure

You'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 [12] during the procedure. If you have urgent cardioversion, you may still be unaware of the pain [12] involved, or you may feel a jolt that some people liken to a kick in the chest.

Possible Complications

• Inability to stop the abnormal rhythm
• Resumption of the abnormal rhythm after a normal rhythm was established
• Development of a more dangerous dysrhythmia
• Damage to the heart [2] muscle [8]
• Blood clots introduced into your circulation, leading to such complications as stroke [13] or damage to your intestines, kidneys [14], or limbs
• Burning or irritation to the skin of the chest where the paddles or electrodes are applied
• Death

Average Hospital Stay

Elective 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 Care

You 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.