Procedures

Cardioversion

Why has my cardiologist recommended a cardioversion?

A cardioversion is a procedure where an electrical current is delivered to correct an irregular or rapid heartbeat.
It is a very short procedure (minutes) requiring a brief general anaesthesia and just a few hours in hospital.
Electrical cardioversion is generally very successful with most patients awakening in normal cardiac rhythm after the procedure.

Why has my cardiologist recommended a cardioversion?
Cardiac rhythm problems are common in the community.
Common examples include atrial fibrillation and atrial flutter.
These rhythm problems result in fast or irregular heart beating.

When your heart beats too fast, it struggles to pump your blood around your body properly. This may cause symptoms such as:

Palpitations
Dizziness or blackouts
Shortness of breath
Tiredness
Chest pain

Often when these rhythm abnormalities occur your heart will become ‘stuck’ in the rhythm needing an electrical reset to return to normal, especially if medication hasn’t managed to restore normal rhythm (sinus rhythm). This electrical rest is called a ‘cardioversion’.

What is a cardioversion?

Why have I been referred to a different cardiologist for this procedure?

Usually, your own cardiologist will perform the cardioversion in the CCU.
However, for some patients there is a small chance of clot formation prior to starting a ‘blood thinner’ medication. If your cardiologist is concerned about this he/she may refer you to a colleague to perform a special ultrasound procedure prior to cardioversion, known as a TOE (trans-oesophageal echocardiograph). This is performed by cardiologists that have undertaken additional training in cardiac imaging. Western Cardiology has a number of team members with this special skill. The TOE and the cardioversion are done at the same time.
The new cardiologist will communicate closely with your own cardiologist throughout.

What should I expect during a cardioversion?

Western Cardiology provides hospital-based care at SJOG Hospital in Subiaco.
Cardioversions are performed in the CCU or Ward 32. You will meet some of the team and the nurses will run through a check list and check that a consent form is completed. An IV drip will be inserted and you will be connected to a monitor.
Your cardiologist will then:

Attach pads to the chest (note that these do feel cold).
Attach an external defibrillator to monitor your heart rhythm
Once asleep, a shock will be delivered to reset the heart rhythm to normal.
You should expect the procedure to take 15 – 20 minutes.

How should I prepare for a cardioversion?

You will likely by started on a ‘blood thinner’ prior to your procedure.
You will need to fast for 6 hours prior to an elective cardioversion.
You will be provided with instructions by your cardiologist for your other medications.

Before the day of the procedure, please register with St John of God Subiaco Hospital admissions at www.sjog.org.au/myadmission and complete the online Admissions Form and follow their instructions. If you require any assistance please call 1300 863 566.

On the day of your procedure please bring in your Medicare card, private insurance details, and all your current medications. You will have receive further details about where to present to on the day.

What are the risks associated with a cardioversion?

A Cardioversion is a safe, common procedure, performed by one of our cardiologists.
The main risks associated with cardioversion are the small risks of the general anaesthetic and a very small risk of stroke, around 1 in 200. This is minimised by taking a ‘blood thinner’ prior to and after the cardioversion, as advised by your cardiologist.
Skin irritation can sometimes occur at the site on the chest where the electrodes are placed.

Aftercare requirements

You will awaken quite quickly after the cardioversion.
Discharge is usually possible with 2-3 hours, after a period of observation.
You should not drive for at least 24 hours after anaesthesia. It is thus preferred that you are discharged to the care of a family member or friend for that first day.
You can usually resume normal activities the following day.
You will be required to remain on the blood thinner (anticoagulant) for at least 4 weeks after cardioversion and possibly longer under the advice of your cardiologist.
Please note, it is not uncommon for the irregular heart rhythm to recur prior to your planned follow up appointment. Should this occur, please contact Western Cardiology on 9346 9300 or if unwell the SJOG CCU Mobile : 0411 707 017