Have you ever felt like your heart was suddenly beating faster or faster than usual? Do you ever feel like something is spinning in your chest and you find it hard to breathe? Today we're going to talk about a special treatment that doctors use to restore normal heart rhythms (arrhythmias) in cases like this. This is called cardioversion.
Simply put, what is Cardioversion?
Cardioversion is a medical procedure that doctors perform to restore your heart's irregular rhythm, or rhythm. Think of it like retuning a musical instrument that has lost its rhythm. This can be done in two ways. One is by using an electronic device. The other is by giving you medication. In some emergencies, such as a condition called ventricular arrhythmia, this treatment can save your life. In other cases, it is done to prevent future complications.
What are the main types of cardioversion treatment?
As we said before, this is done in two main ways. Let's understand it clearly.
| Type of treatment | How it works |
|---|---|
| Electrical Cardioversion | This involves delivering a controlled amount of electrical energy (shock) to your chest using a special device called a defibrillator . This is done through two special pads (electrode patches) that are placed on your chest and back. This is done after you are asleep, so you won't feel any pain. For people who are at high risk for dangerous heart rhythm problems, a small device called an Implantable Cardioverter-Defibrillator (ICD) may also be used. |
| By medication (Chemical Cardioversion) | This involves giving you medication either as a pill that you swallow or through an IV that is given into a vein in your arm. The medication can take minutes, hours, or even days to work. This treatment is often done in a hospital setting because your heart function needs to be monitored. If you are taking your medication at home, it is important to stay in close contact with your doctor. |
What conditions is cardioversion used for?
This treatment is used to correct a number of fast or irregular heart rhythms. Some of these include:
- Atrial Fibrillation and Atrial Flutter: These are the two conditions most commonly treated with cardioversion.
- Atrial Tachycardia
- Ventricular Tachycardia
- Ventricular Fibrillation: This is a very urgent and life-threatening condition.
Why do I need cardioversion treatment?
For your heart to pump the right amount of blood to your body, it needs to have the right beat and rhythm. When your heart beats irregularly, you may experience symptoms like:
- My chest suddenly feels like it's pounding loudly, like I'm being hit by a fine.
- Difficulty breathing.
- Chest discomfort or pain.
- Feeling dizzy or extremely tired.
These symptoms mean that your heart is not pumping enough blood to your body. Even if you don't notice these symptoms, if left untreated, you are at greater risk of developing serious conditions such as a heart attack or stroke in the future.
How do you prepare for the day of treatment?
Your medical team will give you detailed instructions on this, but there are some general things to keep in mind.
The day before and the morning of treatment
- Driving: You will not be able to drive for 24 hours after treatment. Therefore, it is essential that you have someone to drive you home.
- Food and Drink: Eat normally the night before your treatment. However, do not eat, drink, or chew anything after midnight that night. This includes water, chewing gum, or mints. Also, be careful not to swallow water while brushing your teeth.
- Medications: If you are taking anticoagulants (blood thinners) or diabetes medication, be sure to ask your doctor how to take them on the day of your treatment. Take other common medications as usual with a little water, unless your doctor tells you not to.
What should you do when you arrive at the hospital?
- Clothing: Wear comfortable clothing that is easy to put on and take off. You will be required to wear a hospital gown during your treatment.
- Cleanliness: Do not wear makeup or nail polish. Also, do not apply any deodorant, powder, or cream to your chest or back. These may interfere with the adhesive pads used for treatment.
- Valuables: Leave all jewelry, watches, and valuables at home, including wedding rings.
What happens during and after treatment?
Preparation before treatment
You will be placed on a bed and an IV line (intravenous line) will be inserted into a vein in your arm. This will be where you will receive the necessary medications and fluids during the treatment. Then, EKG pads and Cardioversion pads will be placed on your chest and back. If there is any hair in those areas, they will be removed.
You may also need to have a test called a Transesophageal Echocardiogram (TEE) before cardioversion. This involves numbing your throat and passing a thin tube down your throat to take pictures of your heart to check for blood clots, which can be dangerous if they break loose during the treatment.
Am I awake?
No. You are given medication through an IV and put to sleep. So you don't feel anything, no pain.
During treatment
While you are asleep, your doctor uses a cardioverter machine to deliver a controlled amount of electrical energy (shock) to your heart through pads. This energy stops the irregular electrical rhythm and allows it to return to a normal rhythm. This may need to be done several times to restore the rhythm.
| Things and equipment to monitor during treatment | |
|---|---|
| Device | Task |
| Cardioverter / Defibrillator | Providing electrical energy to the heart. |
| Electrocardiogram (ECG/EKG) | Continuous monitoring of the heart's electrical activity. |
| Blood Pressure Monitor | Measure your blood pressure. |
| Oximeter | Measuring blood oxygen levels with a small clip attached to the finger. |
After treatment
After the treatment, you will wake up. You will feel drowsy due to the medication you have been given. Your chest may feel a little sore and numb for a few days. If your doctor approves, you can use something like a `Hydrocortisone` cream for this. When you are fully awake, your doctor will talk to you about the results and your future treatment plan.
What are the benefits and risks of the treatment?
As with any medical procedure, there are benefits as well as some very minor risks.
- Benefits: The main benefits are normalization of the heart rhythm, reduction of symptoms, and more efficient pumping of the heart.
- Risks: Complications are rare, but they can include redness where the pads are attached to the skin, bruising where the IV was inserted, a blood clot in the heart that breaks loose and causes a stroke (this is what the TEE test is done to prevent), worsening of heart rhythm, or an allergic reaction to the medication.
You can usually go home the same day. But you shouldn't drive for 24 hours. You can eat and drink normally after treatment. Talk to your doctor to find out when you can return to work.
Take-Home Message
- Cardioversion is a very effective and safe treatment used to correct irregular heartbeats.
- This is done by putting you completely asleep, giving you controlled electrical energy, or using medication. You will not feel any pain.
- Follow your doctor's instructions carefully before treatment, especially regarding food, drink, and blood-thinning medications.
- Since you cannot drive for 24 hours after treatment, it is essential to have someone with you to take you home.
- If you have symptoms like chest tightness, difficulty breathing, or dizziness, don't ignore them. See your doctor immediately.
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