An electrical cardioversion (C/V) is a medical procedure that uses a controlled, therapeutic electrical shock to reset an abnormal heart rhythm, such as atrial fibrillation (AFib), back to a normal, synchronized pattern. While the delivery of the electrical energy itself is virtually instantaneous—lasting only a fraction of a second—the total time a patient spends at the medical facility is significantly longer. The entire patient journey from check-in to safe discharge typically requires several hours. This extended period accounts for necessary safety protocols, preparation, the procedure under sedation, and a mandatory recovery period.
Pre-Procedure Preparation
The preparation phase begins immediately upon arrival and is crucial for patient safety, typically lasting between 60 to 90 minutes. A primary prerequisite is fasting, which requires the patient to avoid food and drink for at least eight hours prior to the scheduled time. This measure is necessary because the procedure is performed under deep sedation or general anesthesia, and an empty stomach minimizes the risk of aspiration. Upon check-in, the medical team verifies the patient’s identity, reviews consent documents, and conducts baseline checks of vital signs. A nurse establishes an intravenous (IV) line for delivering the short-acting sedative medications, and the team attaches electrocardiogram (ECG) monitoring leads and places the large defibrillator pads on the patient’s chest and back.
The Core Procedure and Immediate Stabilization
The actual time spent inside the procedure room is remarkably brief, generally ranging from 5 to 15 minutes. Once the patient is positioned and monitors are confirmed to be functioning, the anesthesiologist administers the short-acting sedative medication through the established IV line. This quickly induces a state of deep sleep, ensuring the patient feels no pain or discomfort during the electrical shock.
As soon as the patient is fully sedated, the cardiologist delivers the synchronized electrical current through the pads. The shock is timed precisely to a specific point in the heart’s electrical cycle to maximize the chance of success. Following the instantaneous shock, the medical team immediately checks the heart rhythm on the monitor to confirm conversion to a normal sinus rhythm. If the first attempt is unsuccessful, a second or third shock at a higher energy level may be administered quickly.
Post-Procedure Monitoring and Discharge
The recovery and monitoring phase is the longest portion of the entire cardioversion process, often requiring 2 to 4 hours before discharge. The most immediate concern is allowing the patient to safely wake up and recover from the effects of the sedative. During this time, the patient is moved to a recovery area and continuously monitored.
Continuous telemetry (ECG monitoring) is maintained to ensure the newly restored heart rhythm remains stable and does not revert to the abnormal rhythm. Nurses frequently check the patient’s blood pressure, heart rate, and oxygen levels to detect any adverse reactions to the sedation or the shock.
Once the patient is fully awake, alert, and able to sit up, the nurse provides comprehensive discharge instructions. These include reviewing new or adjusted medications and stressing the need to continue taking any prescribed blood-thinning agents. Due to the lingering effects of the sedation, the patient is prohibited from driving or operating machinery for 24 hours. The total time commitment from hospital arrival to walking out the door typically spans between 3 to 6 hours.