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Cardioversion is a procedure used to restore sinus heart rhythm in patients with certain arrhythmias by deploying high-energy electrical shocks to the heart. Alternately, medical cardioversion can be achieved using medication, but no shocks. A cardioversion can often be used for atrial fibrillation, or A-fib, or for atrial flutter. While not as significant as the electrical shocks provided by a defibrillator, a cardioversion still delivers significant energy.

The procedure is most often performed in a hospital setting, but as an outpatient procedure, meaning that the patient will go home on the same day of the procedure. The patient will be hooked up to an external cardioversion machine, and electrodes will be placed on the chest and back. Patients will be sedated to minimize any discomfort

The electrophysiologist will deliver a single shock or multiple shocks to the heart, which most often restores normal heart rhythm.

Considerations of Cardioversion

  • While cardioversion can be effective in “resetting” the heart’s rhythm, it can cause some significant side effects, including dislodging a blood clot from the left atrial appendage of the heart. These clots can travel to the lungs, causing a pulmonary embolism, or to the brain, causing a stroke. As a result, patients will certainly be prescribed anticoagulants after the procedure, but may be prescribed these medications prior, as well.
  • A cardioversion may also induce another arrhythmia. Typically, this occurs shortly after the initial shock treatment, and therefore can be treated by the electrophysiologist on the spot.
  • The cardioversion may fail to restore normal heart rhythm.
  • The root cause of the arrhythmia may not be addressed and may eventually require a procedure, such as a catheter ablation or cryo-ablation, regardless of short-term success.