What is Cardioversion?
Electrical Cardioversion (also known as "direct-current" or DC Cardioversion) is a procedure whereby a synchronized (perfectly timed) electrical shock is delivered through the chest wall to the heart through special electrodes or paddles that are applied to the skin of the chest and back Special Cardioversion pads are placed on your chest and back (or alternatively, both pads can be placed on the front of the chest). The pads are connected to an external defibrillator by a cable. The defibrillator allows the medical team to continuously monitor your heart rhythm and to deliver the electrical shock. The goal of the Cardioversion is to disrupt the abnormal electrical circuit(s) in the heart and to restore a normal heart beat. The shock causes all the heart cells to contract simultaneously, thereby interrupting and terminating the abnormal electrical rhythm (typically fibrillation of the atria) without damaging the heart. This split second interruption of the abnormal beat allows the heart's electrical system to regain control and restore a normal heartbeat.

Why Cardioversion?
Cardioversions are performed to convert fast or chaotic heart rhythms back to normal.  With this procedure an electrical shock is sent to the heart via the chest wall.  This shock momentarily stops the irregular rhythm and allows the normal pacemaker of your heart to take over producing a sinus rhythm.  The sinus node is the normal pacemaker (area in your heart that provides a stimulus for your heart to beat normally).  Cardioversions are performed most commonly for individuals with atrial fibrillation; however, other heart rhythms may be cardioverted also.  

With atrial fibrillation the top chambers of your heart are quivering so that the chambers cannot squeeze to propel the blood to the ventricles (bottom chambers of the heart).  This allows the blood to pool and clot within the atria (top heart chambers).  Clots within the heart may dislodge during the cardioversion and cause complications such as a stroke.  To prevent this from occurring, a transesophageal echocardiogram (TEE) may also be suggested by your physician to assess for the presence of a blood clot within your heart.  Some physicians may place you on Coumadin (a blood thinner) for several weeks prior to the procedure.  The Coumadin prevents blood clots from forming in your heart.

 Preparing for your Elective Cardioversion:

• Do not eat or drink anything for approximately 6-8 hours before the procedure.
• Ask your doctor if you should take your usual medications.
• You will need to bring the order for your procedure (paperwork from your Physician) with you.
• You will not be able to drive following your procedure, so please make transportation arrangements.
• Please bring a written list of your daily medications (or bring your medications) with you to the hospital.
• Allow 1 - 2 hours for your visit with us.  (The procedure itself takes 10 - 15 minutes on average.)

• You will check in at Registration on first floor just inside the Main Entrance.  
• Give your order for procedure (paperwork from your Physician) to the Registration clerk.
• The Registration clerk will ask you a few questions in order to update your information in the computer.  Be sure to bring your insurance card with you if you have one.
• The Registration clerk will give you directions on how to get to the Cardiology Department on 2nd floor.  

• You will be asked to sign a consent form.  A staff member will be available to explain the procedure or answer any questions you may have.
• You will be asked questions regarding your medical history.  
• An IV will be placed in your arm to allow you to receive medications during the procedure.  
• You will be connected to a cardiac monitor to observe your blood pressure, heart rate and rhythm, and oxygen levels during the procedure.
• Once the physician arrives, you will be given medication for sedation.  Pads will be placed on your chest and back.
• Once you are asleep, an electrical shock will be delivered through the pads to convert your heart rhythm to a normal rhythm.

• After the procedure, if no further immediate treatment is necessary, you will remain in the department for approximately 30 minutes for the recovery period.  
• Your vital signs will be monitored while you awaken from the sedation you received.
• You will receive written discharge instructions to take home with you.
• If your doctor starts you on new cardiac medications, you may be admitted you to the telemetry floor to monitor your heart rhythm.