Electrical cardioversion is an established procedure that has eliminated atrial fibrillation (Afib or AF) for many patients. For other patients, it makes Afib symptoms go away on a long-term basis. If you are considering electrical cardioversion, then you may be seeing a specially trained cardiologist called an electrophysiologist who can confirm that you are a good candidate for the procedure.
If you decide to go forward with electrical cardioversion, your care team will review how you should prepare for the procedure, what will happen during the procedure and what to expect afterwards. Here we review some general information about electrical cardioversion.
Testing Before Electrical Cardioversion
Before you undergo electrical cardioversion, your care team will talk with you about your symptoms, including when you first noticed them and how long they usually last. Be sure to answer their questions as fully as you can, as this information will help your care team develop a complete picture of your condition and develop a plan for how to address it. It is usually a good idea to bring a family member or friend who is familiar with you to appointments because he or she can help you remember details and answer questions.
Your medical team will also order tests to check on your overall health and how your heart is doing. These may include a transesophageal echocardiogram (TEE). A TEE test is used to check for blood clots in your heart. (If the test does find a clot, you may be asked to take blood-thinning medications called anticoagulants until the clot is resolved. Most people with atrial fibrillation take an anticoagulant medication and there is usually no need to stop taking this medication before cardioversion. You can learn more about TEE testing here.
About Your Electrical Cardioversion Procedure
Before your catheter ablation procedure, your care team will review all of the details about what to expect before, during and after the procedure. Your information will be tailored to your situation, but some general information is as follows:
- The procedure is minimally invasive. This means your chest will not have to be opened up for surgery.
- Electrical cardioversion is performed in hospitals equipped with an electrophysiology laboratory.
- You will not be allowed to eat or drink anything for at least 12 hours before the procedure. Your care team will tell you exactly how long to avoid eating and drinking and whether you should or should not take your usual medications before the procedure.
- In most cases of elective cardioversion, people with atrial fibrillation will be taking an anticoagulant (blood-thinning) medication. Usually it is not necessary to stop these medications before the cardioversion.
- You will be anesthetized so that you sleep through the procedure and are unaware of everything. You will not feel any pain or sensation.
- Your doctor will be able to tell you the results of the procedure almost immediately after you wake up. You may feel groggy or sleepy, so your care team will wait to talk with you until you are fully awake.
- A family member or friend should drive you to and from the hospital and should be available to help you for the first day you are home.
What Happens During an Electrical Cardioversion Procedure?
When it is time for your procedure, a nurse will take you to the electrophysiology laboratory, where your electrophysiologist and other members of the medical team will be ready and waiting for you. You will lie on a table and the medical team will place small patches (electrodes) on your chest and possibly on your back. The electrodes will be connected to a cardioversion machine, known as a defibrillator. The electrophysiology laboratory is equipped with various monitors so that your team can follow how your heart is doing throughout the procedure.
Next, your medical team will administer a sedative through an intravenous (IV) line in your arm. You will go to sleep almost immediately and will be completely unaware of the procedure. The IV line may also be used to administer other medications needed during the procedure.
Once the electrodes are in place and you are asleep, the defibrillator will be used to deliver a small shock to your heart. This shock is what “resets” your heartbeat to normal sinus rhythm.
After Your Electrical Cardioversion Procedure
After the procedure is completed, you will be moved to a recovery room, where nurses will keep an eye on you until you wake up from the sedative. You may feel groggy or sleepy for a little while. Once your doctor has examined you and confirmed that you are strong enough to go home, you will be discharged from the hospital. A family member or friend should drive you home and stay with you for at least the rest of the day. You should not attempt to work, exercise or do anything strenuous until your doctor tells you it is okay to do so.
After your cardioversion procedure, your cardiologist or electrophysiologist will make sure that you are taking a blood-thinning medication (anticoagulant) for at least a month in most cases. Although the cardioversion will put your heart back in normal rhythm, for the first few weeks there is still a risk of blood clots forming in the heart. So even if you had a transesophageal echocardiogram prior to the cardioversion that showed no clot, precautions must be taken to prevent one from forming after the procedure.
Your doctor will want to see you for a follow-up exam to make sure your heart has remained in rhythm.
Life After Electrical Cardioversion
No matter how well your electrical cardioversion procedure works, the most important factor in its continued success is you. A heart-healthy lifestyle will provide your heart with optimal conditions for good health, and will allow the cardioversion to have its maximum beneficial effect. Talk to your doctor about the following:
As always, you should have good communication with your doctor and your medical team. Ask all questions – even questions you might think are trivial or embarrassing. Your care team will be on hand to help you through not just the procedure but also your recovery and long-term journey toward heart health.
To learn more about procedures used to treat atrial fibrillation, visit the SecondsCount Atrial Fibrillation information center found here.
And for information about options for treating atrial fibrillation symptoms, check out these SecondsCount articles: