This procedure is used within a hospital setting to convert an irregular heart rhythm to a normal heart rhythm by applying brief high-energy shock. Common rhythms that require cardioversion include atrial fibrillation and atrial flutter. Life-saving cardioversion may be used with ventricular tachycardia.
What to Expect: The patient lies on a bed and a nurse will start an intravenous (IV) line into the arm or hand in order to give medications and fluids during the procedure. The nurse will connect the patient to several monitors. Electrode patches will be attached to the chest and upper back. Men may have their chest hair shaved for electrode placement. A medication will be given through the IV to cause sleep. While asleep, the doctor will use a special machine that delivers specific amounts of energy through the patches to the heart muscle to restore a normal heart rhythm. Although this procedure only takes a few seconds, several attempts may be needed. In some people, a moderately invasive imaging test called a transesophogeal echocardiogram (TEE) may be performed prior to the cardioversion to make sure the heart is free from blood clots. The TEE is performed by swallowing a narrow tube with a ultrasound probe at its tip that can be placed against the back wall of the heart. Testing takes approximately 1 hour.
Preparation: Do not eat or drink anything after midnight the evening before the test, or at least 6 hours prior. Take all medications as prescribed, but drink only small sips of water with pills. If diabetic, check with your doctor about how to adjust your diabetic medications. Those taking anticoagulants (such as Coumadin, Pradaxa, Xarelto, Eliquis, Plavix, etc.) should continue these medications unless otherwise instructed.
Wear comfortable clothes to the hospital. The patient will change into a hospital gown prior to the procedure. It is best not to wear any jewelry or valuables. Most patients will be able to go home after the test . A companion will be required to drive the patient home as sedation is used during the procedure. Some chest wall tenderness (similar to a sunburn) may be present for a few days after the cardioversion. Your doctor may recommend creams or over-the-counter medications to help with this possible issue.