• Treating Atrial Fibrillation with Electrical Cardioversion


    If you have atrial fibrillation (Afib or AF), your care team will likely be led by cardiologist or even a specially trained cardiologist called an electrophysiologist. An electrophysiologist is a cardiologist with special training in irregular heartbeats (arrhythmias). If your symptoms have not been successfully managed with lifestyle changes and medications, then your cardiologist may recommend that you consider a treatment called electrical cardioversion to reduce your symptoms. Electrical cardioversion is a minimally invasive procedure that uses a mild electric shock to “reset” your heartbeat so it beats normally (this is called normal sinus rhythm).

    Who Benefits From Electrical Cardioversion?

    Electrical cardioversion is a treatment that has been successfully used to treat Afib for many years; however, it is not necessary for all patients who have Afib. Whether your doctor recommends electrical cardioversion for you may depend on how long you have been having Afib symptoms and how much your symptoms bother you.

    Keep in mind that electrical cardioversion works better for some people than others. In some people, electrical cardioversion may immediately reduce Afib symptoms, while in others the procedure may be unsuccessful. If you are considering an electrical cardioversion procedure, you will want to talk with your doctor about your expectations and how effective electrical cardioversion usually is for people like you.

    How Does Electrical Cardioversion Help with Atrial Fibrillation?

    Atrial fibrillation is a type of heart arrhythmia that causes the heart to beat erratically and the upper chambers of the heart (the atria) to quiver (fibrillate). If you have Afib, your heart may beat too quickly and then slow down so much that you feel weak and dizzy, or you may even lose consciousness. Atrial fibrillation is the most common type of heart arrhythmia. The American Heart Association estimates that 2.7 million people are living with Afib.

    During an electrical cardioversion procedure, you will be sedated. This means that you will be asleep and will not feel anything during the procedure. Small patches, called electrodes, will be placed on your chest and possibly on your back. These electrodes are connected to a machine called a defibrillator, which will be used to deliver a mild shock to your heart. The shock will “reset” your heartbeat to its normal sinus rhythm. Some people think of the shock as being a little like restarting your computer when it acts up or freezes. By restarting, you clear the problem and can get on with your work.

    Electrical cardioversion is usually a very short procedure, but you may feel groggy or sleepy for a little while after the procedure is completed. You will stay in the hospital until your medical team is certain you are strong enough to go home. You will need a family member or friend to drive you home and then stay with you for at least a day.

    What Are the Benefits & Risks of Electrical Cardioversion?

    The main benefit of electrical cardioversion is that it may be able to restore your heartbeat to its normal sinus rhythm without surgery and without a lengthy hospital stay. Most people are able to resume their normal activities in a day or two following a successful procedure.

    It is important to note that no procedure is without risks. Electrical cardioversion is no exception. Some of the complications of an electrical cardioversion procedure include:

    • An undetected blood clot in the heart could be dislodged and cause a stroke. (To help prevent this complication, your doctor will perform a transesophageal echocardiogram (TEE) to check for clots.)
    • While it is rare, the shock given to the heart during the procedure could cause a life-threatening irregular heartbeat.
    • Sometimes the electrodes that are placed on the chest may cause minor burns on the chest.

    It is also possible that the electrical cardioversion procedure will not work as you and your care team hoped. If this occurs and your irregular heartbeat returns after the procedure, then you and your doctor will need to review your treatment options. You may decide to have a second cardioversion procedure or to try another treatment, such as implanting a pacemaker or undergoing catheter ablation. In catheter ablation, an electrophysiologist treats the “hot spots” in the heart muscle with hot or cold energy to cause the tiny amount of problem tissue to die. You can learn more about catheter ablation here.

    Ask Questions

    Your medical team will discuss the benefits and risks of electrical cardioversion with you. It is always a good idea to have a family member or friend with you when discussing your medical condition and treatment options. Together you can take notes and ask all of your questions.

    Learn More

    To learn more about electrical cardioversion and other procedures for treating Afib symptoms, visit these SecondsCount articles: