Let's learn about chemical cardioversion, a method of correcting the heart's rhythm by administering medication.

Have you ever felt your heart suddenly beat faster for no reason, or felt a strange fluttering sensation like butterflies in your chest? These types of changes in heart rhythm (irregular heartbeat) are sometimes something to be concerned about. Today, we're going to talk about a special treatment that doctors use to treat these types of irregular heartbeats.

Simply put, what is Chemical Cardioversion?

Simply put, chemical cardioversion is the use of medications to return your heart's abnormally fast or irregular rhythm to a normal rhythm. The success of this treatment depends on the cause of your irregular heartbeat, how long it has been present, and the type of medication your doctor chooses.

We also call this Pharmacologic Cardioversion. The medications given during this treatment do several main things:

• It relaxes your blood vessels.
• Provides relaxation to the heart muscles.
• Reduces the workload on the heart.
• It controls the speed at which electrical signals tell the heart to beat.

When the heart rhythm is irregular, it doesn't pump enough blood throughout the body. Every cell in our body, especially the brain, needs a constant supply of oxygen from the blood. When blood flow is disrupted in this way, you can experience symptoms like dizziness, fatigue, shortness of breath, and chest pain .

Why is this treatment used and for what diseases?

If your heartbeat is too fast or irregular, you may need chemical cardioversion. There are several reasons why your heart rhythm may be irregular.

• Some of the medications you use
• Infectious conditions like pneumonia
• Heart attack
• Changes in the structure of the heart
• Pulmonary embolism
• Congestive heart failure
• Lung diseases such as COPD or Emphysema

Chemical Cardioversion is mainly used to treat the following irregular heartbeat conditions:

What happens before treatment?

Your doctor will decide which treatment is best for you (medication or electrical cardioversion). If your blood pressure is very low, your doctor may choose electrical cardioversion.

• Food and Drink: You will be advised to refrain from eating or drinking for about 8 hours before this treatment.
• Tests: If you have an irregular heartbeat (atrial arrhythmia) for more than two days, your doctor may do a test called a Transesophageal Echocardiogram (TEE) . This is to check for blood clots inside the heart. This can cause a stroke if the clot breaks loose during treatment.
• Medication: You should tell your doctor about all the medications you are taking, including over-the-counter medications, vitamins, and even Sinhala medications . You may also be asked to start taking anticoagulants three weeks before your treatment to reduce the risk of blood clots.

What happens during treatment?

This treatment is usually done in the intensive care unit (ICU) of a hospital or in a special room set aside for it. This is because there is a small risk of other types of irregular heartbeats when the medication is given, so you need to be closely monitored.

You are not alone at this time. Doctors and nurses are by your side, continuously monitoring your blood pressure and heart rate (ECG). All necessary equipment (such as a defibrillator) is ready in case of an emergency.

The medicine is given to you as a pill that you swallow or through an IV in a vein in your arm . Sometimes, if the first dose of medicine doesn't work, another dose may be given.

Commonly used medications

The type of medication you are given will vary depending on your condition. Some of the most commonly used medications are:

• Amiodarone (Cordarone®)
• Procainamide
• Ibutilide
• Flecainide
• Propafenone (Rythmol®)
• Sotalol (Betapace®)
• Beta-blockers such as metoprolol (Lopressor®)
• Calcium channel blockers such as diltiazem (Cardizem®)
• Adenosine (Adenocard®)

What are the pros and cons of the treatment?

You may be kept in the hospital for observation for 24 to 48 hours after treatment. Some people may feel a little tired or uncomfortable from this medicine.

Advantages:

• The heartbeat can be brought back to a normal rhythm.
• Symptoms such as dizziness and fatigue are reduced.
• It can be used as an alternative to electrical cardioversion.

Risks and Complications:

• The onset of a new irregular heartbeat or worsening of an existing one.
• A blood clot can break loose and cause a stroke .
• Side effects such as nausea and fatigue.
• Some medications can take months to work.
• If this treatment is not successful, you may need to resort to other treatments such as electroconvulsive therapy or catheter ablation.
• Medications don't work equally well for everyone. Sometimes, the long-term success rate is about 50%.

When should you seek immediate medical advice?

If you experience any of the following unusual symptoms after Chemical Cardioversion, go to the nearest hospital Emergency Department (ETU) immediately or call the 1990 ambulance service. Do not ignore these.

• Heart palpitations
• Severe dizziness
• Lightheadedness
• Weakening of the body
• Sudden sweating
• Chest pain
• Difficulty breathing
• Allergy symptoms such as hives

Take all medications your doctor prescribes, both before and after treatment, exactly and on time. If you have any questions, never be afraid to ask your doctor.

Heartbeat, Heart palpitations, Chemical Cardioversion, Medication, Heart disease, Atrial Fibrillation, Emergency care, Heart attack, Chest pain