Cardioversion

Cardioversion is a medical treatment used to restore a normal heart rhythm in those experiencing an irregular and often very rapid heart rhythm. It is commonly performed to treat atrial fibrillation (AFib), atrial flutter, and other fast forms of irregular heart rhythms or arrhythmias.

Cardioversion is typically scheduled but may also be performed as an emergency treatment when necessary to quickly reset the heart rhythm.

At Sydnor Cardiovascular Center, our board-certified cardiologist, Dr. Lilian Ahiable, provides safe and effective cardioversion with personalized care to help you regain a stable heartbeat and improve your overall heart health.

Understanding Cardioversion

Cardioversion involves delivering controlled, low-energy electrical shocks to the heart to restore a normal rhythm. It is commonly recommended for those experiencing irregular or rapid heartbeats that may cause uncomfortable symptoms or increase the risk of serious complications, such as stroke or heart failure.

A normal heartbeat begins in the sinoatrial (SA) node, which is a cluster of specialized pacemaker cells located in the upper right chamber (right atrium) of the heart. These cells generate electrical impulses that travel in an organized manner through your heart, causing it to contract in a coordinated, rhythmic pattern. This ensures efficient blood flow throughout your body.

In people with irregular heartbeats, this normal electrical activity becomes disorganized. Instead of a single, coordinated signal from the SA node, multiple chaotic electrical impulses spread through the atria, causing them to quiver rather than contract properly. This can lead to an irregular or excessively fast heartbeat, reducing your heart’s ability to pump blood effectively.

Symptoms indicating the need for cardioversion include:

Rapid or irregular heartbeat
Shortness of breath
Dizziness or fainting
Chest discomfort or palpitations
Fatigue or weakness

If you experience any of these symptoms, seeking a prompt evaluation with our cardiologist can help determine if cardioversion may help.

Types of Cardioversion

There are two primary types of cardioversion, and the choice between them depends on factors such as the type and duration of the arrhythmia, underlying heart conditions, and your overall health.

1. Electrical Cardioversion

Electrical cardioversion involves delivering a carefully controlled electrical shock to the heart through electrode pads placed on the chest and, in some cases, the back. The shock momentarily stops the heart’s abnormal electrical activity, allowing the SA node to reset and restore a normal rhythm.

Electrical cardioversion is:

Performed under sedation
Quick and effective
Performed using image guidance

Electrical cardioversion is often the preferred option for people with persistent arrhythmias who require immediate rhythm correction.

2. Chemical Cardioversion

Chemical cardioversion restores normal heart rhythm using antiarrhythmic medications instead of an electrical shock. These medications work by stabilizing the heart’s electrical activity and suppressing abnormal impulses that cause arrhythmias.

Antiarrhythmic medications may be administered orally or intravenously, depending on your condition.

While some patients respond well to chemical cardioversion, for others, medications alone may be insufficient and necessitate additional treatments, including electrical cardioversion. Chemical cardioversion is often considered for people who:

Have recently developed an arrhythmia
May be at higher risk for complications from sedation
Prefer a non-invasive treatment option

At Sydnor Cardiovascular Center, our expert cardiologist can quickly evaluate your heart condition to determine the most appropriate type of cardioversion for you.

Conditions Treated with Cardioversion

Cardioversion can help correct different types of fast or irregular heart rhythms, including:

Atrial Fibrillation (AFib): AFib occurs when the heart's upper chambers (atria) beat irregularly and rapidly, increasing the risk of stroke and heart failure. Cardioversion can restore normal rhythm in recent-onset cases of AFib.
Atrial Flutter: Similar to AFib but with a more organized rapid rhythm, atrial flutter can cause inefficient blood flow. Cardioversion can be highly effective in resetting a normal heartbeat.
Ventricular Tachycardia (VT): A dangerous arrhythmia originating in the ventricles (lower heart chambers), VT can lead to fainting, chest pain, or cardiac arrest. Electrical cardioversion is often needed, especially in emergencies, to restore normal rhythm.
Ventricular Fibrillation (VFib): A life-threatening condition where the ventricles quiver instead of pumping blood, VFib causes sudden cardiac arrest. Immediate cardioversion is required to restore normal rhythm.

How the Cardioversion Works

At Sydnor Cardiovascular Center, our expert cardiology team ensures a safe, comfortable, and personalized experience, guiding you through the entire process and providing comprehensive care before, during, and after your treatment.

Pre-Treatment Check-Ups

Before performing cardioversion, we conduct a thorough evaluation to assess your heart health and minimize potential risks. Before opting for cardioversion, we may perform the following tests and reviews to ensure your safety.

Electrocardiogram (EKG): A detailed assessment of your heart rhythm to determine the best approach for restoring normal function.
Echocardiogram: An ultrasound of the heart to check for blood clots, since cardioversion could potentially dislodge them and cause serious complications.
Blood tests: A comprehensive evaluation of your overall health to ensure a safe treatment.
Medication review and adjustments: If necessary, we adjust your medications, including prescribing blood thinners to reduce the risk of stroke.

If a blood clot is detected, cardioversion is typically postponed for 3 to 4 weeks while we prescribe you to take blood thinners to lower the risk of complications.

Preparing for Cardioversion

At Sydnor Cardiovascular Center, our team ensures a seamless, stress-free experience during cardioversion treatment. To ensure a safe and effective cardioversion, we advise you to follow these guidelines for your treatment:

Do not eat or drink for at least 8 hours before the treatment.
Take your regular morning medications unless instructed otherwise by your doctor. Use only a small sip of water.
Wear comfortable, easy-to-remove clothing as you may change into a hospital gown.
Avoid applying lotions or ointments to your chest or back, as they can interfere with the electrode pads.

During the Cardioversion

During the treatment, we ask you to lie down and then we place an IV line in your hand or forearm to administer a sedative. This helps you stay relaxed throughout the treatment.

Right before your cardioversion, we may perform a transesophageal echocardiogram (TEE) to check for blood clots in your heart. To ensure your comfort, your throat will be numbed before a thin, flexible tube with a small transducer is gently guided down your esophagus. This transducer captures detailed images of your heart, allowing us to detect any clots that could pose a risk during the procedure.

If you're having chemical cardioversion, we deliver the antiarrhythmic drugs through an IV line to help restore your heart’s normal rhythm. These medications stabilize your heart’s electrical activity and reduce irregular impulses.

The time it takes for chemical cardioversion to be effective varies from person to person. Some people experience a return to normal rhythm within minutes to hours, while for others, it may take several doses over a few hours for the medication to take full effect. Throughout the process, our team carefully monitors your heart rhythm to assess whether the treatment is working. If the medication does not successfully restore a normal rhythm, our provider may discuss alternative options, such as electrical cardioversion or long-term medication management.

If you're having electric cardioversion, we apply electrode patches to your chest (and sometimes your back). If there’s hair in the way, we shave it. These patches are connected to a machine that monitors your heart rhythm and delivers quick, low-energy shock waves.

While you are under sedation, we use a cardioverter machine (defibrillator) to deliver controlled electrical pulses to your heart. These carefully timed shocks disrupt the abnormal electrical activity and help restore a normal heart rhythm. In some cases, multiple shocks may be needed, but you won’t feel any discomfort since you’ll be asleep throughout the treatment.

Throughout the process, our team closely monitors your oxygen level, heart rhythm, and blood pressure to ensure optimal safety and effectiveness.

After Your Cardioversion

After the treatment, you gradually wake up as the sedation wears off, though you may feel drowsy for a while. You spend about an hour in our recovery area, where our team closely monitors your heart rhythm and overall condition. You can typically return home the same day once you are stable. We recommend you arrange for someone to drive you home after your appointment.

While cardioversion is generally safe, some risks do exist. This can include:

Temporary skin irritation from electrode pads
Mild chest tenderness and discomfort
Blood clot formation, especially in people with AFib
Possible recurrence of arrhythmia, requiring additional treatments or medications

Our team takes every precaution to minimize risks. We schedule regular follow-ups to monitor your heart rhythm, adjust medications as needed, and assess the long-term effectiveness of your treatment.

While cardioversion often restores a normal heart rhythm quickly, some people may require additional treatments or lifestyle modifications to maintain heart health. Our team provides personalized guidance on diet, exercise, and heart-healthy habits to support your long-term wellness.

Manage Irregular Heart Rhythms with Cardioversion in St. Petersburg, FL

Dr. Ahiable provides safe and effective cardioversion treatment to restore your heart's rhythm and improve your quality of life. Whether you need electrical or chemical cardioversion, our expert team guides you throughout the process, ensuring comprehensive care tailored to your needs.

To schedule an appointment, call 727-300-2282 or request an appointment online.

Frequently Asked Questions

Is cardioversion painful?

No. Sedation is used for electrical cardioversion, so you won’t feel the shocks during the process as you’ll be asleep. You may feel tenderness and discomfort after the treatment in the area where electrode patches are applied. For chemical cardioversion, medication is administered to correct the rhythm without discomfort.

How long does cardioversion take?

The actual cardioversion process takes only a few minutes, but the entire visit (including preparation and recovery) may last about four to six hours.

Should I take my blood thinner or diabetes medications on the day of my cardioversion?

Check with Dr. Ahiable about how to take your blood thinners and diabetes medications or insulin before your cardioversion. Unless instructed otherwise, continue taking all other regular medications as scheduled, using only small sips of water.

Can I eat before cardioversion?

You can have a regular meal the evening before cardioversion. However, after midnight before your treatment, do not eat, drink, or chew anything, including gum, mints, or water. If you need to brush your teeth, be careful not to swallow any water.

Will I need to stay in the hospital overnight?

No. Cardioversion is an outpatient medical treatment, meaning you can go home the same day.