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Medicines alone are not always able to get your heart back in normal rhythm.  In these cases, an electrical cardioversion may be an option.  This is a brief procedure done in the hospital.  You are usually only in the hospital for a few hours for a cardioversion.  You will have an IV placed in you hand or arm.  Medicine is given through the IV to make you sleepy.  A sticky pad is placed on your chest, and another is placed on your back.  After you are asleep, a machine called a defibrillator delivers an electrical shock through these pads to your heart to “reset” or “convert” it.  The defibrillator reads your heart’s own rhythm, and gives the shock at just the right time to be most effective at returning the heart to a normal rhythm.

Illustration of Where the Pads are Placed 

When the heart has been out of rhythm, there is a chance a blood clot could have formed in the heart.  If a blood clot comes out of the heart, it can travel to the brain and cause a stroke.  Before doing a cardioversion, your doctor will make sure there is not a clot in your heart.  This is usually either done by having you take a blood thinning medicine for a period of time, or doing a procedure called a TEE.  This is a special ultrasound done by placing a scope in your throat to look directly at the heart and see if a clot is there.  If there is a clot, the cardioversion will NOT be done, and you will usually go home on a blood thinner to help dissolve the clot.                                                     

                                                                                             Conversion of A-Fib to Normal Rhythm

Cardioversion frequently returns your heart to normal rhythm, but without medicine it will often go back out of rhythm again.  Because of this, medicines are often given after cardioversion to help your heart stay in normal rhythm.  Be sure to take all medicines prescribed by your doctor exactly as ordered.

 What can I expect after the cardioversion?

  • Because of the medicine to make you sleepy, you will not be allowed to drive or operate heavy machinery the day of the cardioversion.  You are usually able to return to your normal activity the next day.
  • You will gradually wake up over an hour or two.  You will be able to eat and drink once you are wide awake and will usually go home shortly after.
  • The skin under the patches may be red, sore or itchy for 1 to 2 days.   If it is, you can use Hydrocortisone cream on the affected areas.