Cardioversion is a medical procedure done to restore the normal rhythm of the heart in people suffering from some type of arrhythmia (abnormal heartbeats).
Cardioversion can either be done using certain medications or by sending electric shocks to the heart by placing electrodes on the chest. Cardioversion is a pre-planned procedure that is done at the hospital. It is an outpatient procedure, that is, the patient can go home on the same day as the procedure. It normally restores the normal heart rhythm in most cases.
Types: The two types of cardioversion procedures include:
1. Chemical or pharmacologic cardioversion:
If the heart arrhythmia is not a medical emergency, the doctor will use medications to get the heart back to normal.
The medication is normally given through an IV (intravenously), that is, injected directly into a vein.
Sometimes, medication can be given orally in the form of a pill.
The type of medication used depends on the type of abnormal heart rhythm you may have and any other medical problems you may be having.
The different types of medications that may be used include Amiodarone, Dofetilide, Ibutilide, Flecainide, Propafenone.
2. Electrical cardioversion:
Medications alone may not be able to correct the heartbeat.
In electrical cardioversion, shocks are given through paddles for regulating your heartbeat.
Mild electric shocks help in getting your heart rhythm back to normal.
Cardioversion is needed to get the heart rate and heart rhythm back to normal and allow the heart to pump the way that it should.
The cardioversion procedure is performed when the heart rhythms are abnormal and the following symptoms are seen:
The above symptoms may indicate that the heart is not pumping enough blood to the body. Even if the symptoms are mild, it is important to get treatment, as without treatment it could lead to serious complications like a heart attack or stroke (the blood supply to the brain is stopped).
Physical examination: The doctor will assess you physically. Your medical history and family history are noted by the doctor.
Blood tests: This is a lab test to check the various elements in your blood. It also helps in diagnosing underlying medical conditions like diabetes and thyroid disorders.
X-rays: A chest x-ray may help in checking any abnormalities that may be present in the heart, lungs, bones, and blood vessels.
Echocardiogram (echo): An ultrasound is used to create images within the heart. This is done by using high-frequency sound waves.
Electrocardiogram (EKG or ECG): This test measures the electrical activity of the heart, and helps in diagnosing the various heart disorders.
Transesophageal echocardiogram: This test helps in checking for the presence of any blood clots in the heart. The blood clots can break free during cardioversion leading to life-threatening complications. In case of the presence of blood clots, the cardioversion procedure is delayed for three to four weeks. The doctor will prescribe blood-thinning medications during this time to reduce the risk of complications.
Medications will be given through an IV (intravenously) to help you fall asleep during the procedure so that you do not experience any pain from the shocks.
Several large patches are known as electrodes are placed on your chest.
The electrodes are connected to a cardioversion machine known as a defibrillator using wires.
The machine helps in recording the rhythm of your heart and delivering shocks to your heart for restoring a normal heart rhythm.
This machine also helps in correcting the heart’s rhythm if it beats too slowly after a cardioversion procedure.
The procedure takes only a few minutes to complete.
The complications involved with the cardioversion procedure include:
Headaches
Dizziness
Low blood pressure
Discomfort in the chest area
Allergic reactions to the medicines used
Blood clots
Organ damage
Stroke
Pain, bruising, or burning sensation in the area where the electrodes were used
Worsening of the arrhythmia