Cardioversion

What is the purpose of cardioversion?

Cardioversion is an elective procedure used to stop an abnormal or irregular heart rhythm. The goal is to return the patient to normal sinus rhythm. Atrial fibrillation and atrial flutter are the most common abnormal rhythms treated with cardioversion.

How is a cardioversion performed?

There are two types of cardioversions: pharmacologic and electrical.

Pharmacologic Cardioversion

During this type of cardioversion, a medication is used to restore normal (sinus) rhythm. Examples of medications that may be used include flecainide (Tambocor), propafenone (Rhythmol) and ibutilide (Corvert).

Electrical Cardioversion

More commonly, electrical energy is used to restore normal sinus rhythm. This is referred to as direct current cardioversion (DCCV). During an electrical cardioversion, the patient will come to the hospital to have the procedure done. The anesthesia team will use a short-acting medication to make you sleepy. Once you are asleep, the cardiology team will use the electrical energy to stop the irregular or abnormal rhythm. The patient will typically be discharged home the same day.

How safe is the procedure?

Cardioversion is a safe procedure. The procedure is non-invasive and does not require a hospital stay or prolonged observation. Before a cardioversion is performed, additional procedures such as a CT scan or a transesophageal echocardiogram (TEE) may be done to ensure that there are no blood clots in the heart before normal (sinus) rhythm is restored.

When should a cardioversion be discussed?

If you have remained in an abnormal heart rhythm for an extended time, then your doctor may discuss a cardioversion with you as part of your treatment plan.

If you need a cardioversion, it is very important that you take your blood thinners for a minimum of 3 weeks before the procedure and at least 4 weeks after the procedure without missing any doses. This helps reduce the risk of stroke.