Your cardioversion

Introduction

You have been diagnosed with an abnormal heart rhythm. The abnormal heart rhythm causes your heart to pump inefficiently and may cause a blood clot. If it dislodges from the heart it can result in a stroke or other complications. Patients in atrial fibrillation are usually given anticoagulants (Warfarin or novel anticoagulants such as Apixaban or Rivaroxaban) to prevent blood clots and protect them from having a stroke.

Direct current cardioversion is a procedure that aims to return your heart rhythm to normal with a controlled electric shock using a defibrillator machine.

What happens before the procedure?

You will be seen in the pre-assessment clinic before the procedure. This is in the Cardiac Catheter Suite, 1st floor East Wing of the main building.

Eating and drinking

Our new trust guidelines recommends you to fast for at least 6 hours, however, you may have sips of water up until your procedure time. Further instructions will be given during preassessment.

Medications

We will ask you to bring with you the list of all your medications for the pre-assessment. If you are taking Warfarin please bring your yellow book as well.

Your pre-assessment nurse will instruct you on which medicines to take and which to omit the prior to your procedure. If you have regular INR (blood level) checks, it is important that your reading is above 2 for four consecutive weeks prior to your procedure date. If you are taking a novel anticoagulatn such as Apixaban or Rivoroxaban, you should take it regularly for 4-6 weeks without missing a single dose. If you miss medication doses leading up to the procedure or if your INR is not in range, there is a possibility that your procedure may be delayed or cancelled.

During the procedure

You will be taken inside the procedure room on a trolley/bed. Once inside, two cold patches will be applied on your chest.  In order to perform this, two cold patches will be applied on your chest and connected to a defibrillator machine. There is usually one placed on the front of your chest and the other on the side, although one patch may also be placed on your back. ECG electrodes will also be applied on your chest and limbs to monitor your heart rhythm.

The anaesthetist will administer a sedative through an intravenous (IV) line in your arm. You will go to sleep almost immediately and will be unaware of the procedure. The IV line may also be used to administer other medications needed during the procedure.

Once the pads are in place and you are asleep, the defibrillator will be used to deliver an electrical current/shock to your heart. This shock will try to convert the irregular heart rhythm to normal sinus rhythm.

After the procedure

After the procedure, when your vital signs are stable, you will be moved back to the cardiac day unit, where nurses will continue to monitor you until you are fully awake. You may feel sleepy and tired for a while. Once the doctor has confirmed that you are fit to go home, you will be discharged from the hospital. A family member or friend should drive you home and stay with you for at least 24 hours. After your cardioversion procedure, your medications will be reviewed by a doctor, and you will be instructed on which medications to take after you go home.

Instructions after cardioversion

  • You must not drink alcohol for at least 24 hours
  • You must not drive for 24 hours
  • You must not operate heavy machinery or sign any legal documents for 24 hours
  • You must rest for 24 hours and have someone with you.
  • You may have pain relief for any aches you may feel as a result of your procedure.
  • You may feel tired and lethargic for 24 hours after your procedure. Please allow yourself the time to rest and recover fully.

Contact Information

If you have any queries or concerns please, do not hesitate to contact us at the Cardiac Day Unit on 0208 321 2618.

If you want more information on any other health condition/local support group information visit Health Information Library or contact us: chelwest.library.infoservice@nhs.net.

Patient Advice & Liaison Service (PALS)

If you have any other concerns or wish to give feedback about our services, your care or treatment, you can contact the PALS office on the ground floor of the hospital near main reception. Alternatively, you can send us your comments or suggestions on one of our comment cards, available at the PALS office, or feedback form on our website www.chelwest.nhs.uk.

We value your opinion and invite you to provide us with feedback.

T: 020 8321 6261
E: chelwest.wmpals@nhs.net