Cardioversion is a medical procedure designed to restore a normal heart rhythm when it is beating too fast or irregularly. This intervention can utilize either specialized equipment or specific medications to achieve its goal.
Understanding Cardioversion
Cardioversion aims to reset the heart’s electrical activity, allowing it to return to a regular, efficient rhythm. There are two primary methods for performing cardioversion. Electrical cardioversion involves delivering a controlled, low-energy electrical shock to the heart through pads placed on the chest or back. This method allows healthcare professionals to observe the heart’s immediate response and confirm rhythm correction.
Alternatively, chemical or pharmacological cardioversion uses antiarrhythmic medications administered orally or intravenously. These medicines can take minutes, hours, or even days to become effective.
Evaluating Potential Risks
While cardioversion is generally considered safe, potential risks exist. A primary concern is the possibility of blood clots, which can form in the heart, particularly in individuals with certain irregular heartbeats like atrial fibrillation. If these clots dislodge during cardioversion, they can travel to other parts of the body, potentially causing a stroke or a pulmonary embolism. To mitigate this, patients often receive blood-thinning medication before and after the procedure.
Other potential issues include temporary skin irritation or minor burns at the sites where the electrical pads are placed. Occasionally, a cardioversion might lead to other temporary irregular heartbeats, or an existing one could worsen. Adverse reactions to the sedation or anesthesia used during electrical cardioversion are also possible.
Why Cardioversion is Performed
Cardioversion is performed to address heart rhythm disorders, known as arrhythmias, that cause the heart to beat too quickly or irregularly. Common conditions treated include atrial fibrillation (AFib) and atrial flutter, where the upper chambers of the heart quiver instead of beating effectively. This procedure is considered when lifestyle changes or medications alone have not successfully managed the rhythm.
Restoring a normal rhythm is important for several reasons. It can improve symptoms such as shortness of breath, chest discomfort, fatigue, and dizziness. Correcting the rhythm helps the heart pump blood more efficiently throughout the body. This also reduces the risk of stroke, a serious complication associated with certain untreated irregular heartbeats.
What to Expect During and After
Preparation for cardioversion involves specific instructions. Patients are advised not to eat or drink for several hours before the procedure. Blood thinners are prescribed in the weeks leading up to the cardioversion to reduce the risk of blood clots. An ultrasound of the heart, called an echocardiogram, may be performed to check for existing clots.
During an electrical cardioversion, an intravenous (IV) line is inserted to administer a sedative or short-acting anesthesia. Electrodes are placed on the chest, and sometimes the back, which are connected to a machine that delivers the electrical shock. The procedure itself is brief, often lasting only a few minutes.
After the procedure, patients are monitored for several hours as the effects of the sedative wear off. Patients may feel tired or drowsy, and the skin where the pads were placed might be sore or red. Patients can go home the same day but are advised not to drive or operate machinery for at least 24 hours due to anesthesia effects.