Cardioversion

A safe, controlled procedure that uses electrical energy to restore your heart to a normal rhythm when you have atrial fibrillation or other irregular heart rhythms.

What is Cardioversion?

Cardioversion is a procedure used to restore an abnormal heart rhythm back to a normal pattern. The most common reason for cardioversion is atrial fibrillation (AFib), a condition where the upper chambers of the heart beat irregularly and often too fast.

During electrical cardioversion, a controlled electrical shock is delivered to your heart through electrodes placed on your chest. This brief shock interrupts the chaotic electrical signals causing the irregular rhythm and allows your heart's natural pacemaker to regain control, restoring a normal, steady heartbeat.

The procedure is performed while you're under brief sedation, so you won't feel the shock or experience any discomfort during the process.

Who May Need Cardioversion?

Cardioversion may be recommended if you have:

Atrial fibrillation (AFib) causing symptoms like palpitations, fatigue, or shortness of breath
Atrial flutter — a related rhythm disorder
New-onset AFib that hasn't converted on its own
AFib that hasn't responded to medication
Significant symptoms affecting your quality of life
AFib that's making it difficult to control your heart rate

Important: Preventing Blood Clots

Before cardioversion, it's essential to ensure there are no blood clots in your heart. Atrial fibrillation can cause blood to pool in the heart's upper chambers, potentially forming clots. If a clot is present and the heart is shocked back into normal rhythm, the clot could be dislodged and cause a stroke.

To prevent this, Dr. Bleszynski will either:

1.Prescribe blood thinners for at least 3-4 weeks before the procedure (and continue afterward), OR
2.Perform a TEE (transesophageal echocardiogram) immediately before the cardioversion to directly visualize the heart and confirm no clots are present

What to Expect During the Procedure

Preparation

You'll need to fast for 6-8 hours before the procedure. An IV line will be placed for medications and fluids. Electrode pads will be positioned on your chest and back.

TEE (if needed)

If you haven't been on blood thinners, a TEE will be performed first to check for blood clots. This involves passing a small ultrasound probe into your esophagus while sedated.

Sedation

You'll receive medication through your IV that puts you into a brief, deep sleep. You won't be aware of or remember the cardioversion itself.

The Shock

Once you're asleep, a synchronized electrical shock is delivered through the electrode pads. This typically takes just a fraction of a second. One or more shocks may be needed.

Monitoring

Your heart rhythm is immediately monitored to confirm successful conversion to normal rhythm. You'll wake up within a few minutes.

Recovery & Aftercare

Cardioversion is typically an outpatient procedure. Here's what to expect after:

•You'll be monitored for 1-2 hours after the procedure
•You may feel groggy or drowsy from the sedation for several hours
•You'll need someone to drive you home
•Your chest may feel slightly sore where the pads were placed
•Most patients can return to normal activities the next day
•Continue taking blood thinners as prescribed — this is critical to prevent stroke, even after successful cardioversion

Success Rates & Long-Term Outlook

Cardioversion is successful in restoring normal rhythm in approximately 90% of cases. However, AFib can return over time — especially if you've had AFib for a long period or have underlying heart conditions.

To help maintain normal rhythm after cardioversion, Dr. Bleszynski may recommend:

Anti-arrhythmic medications to help prevent recurrence
Lifestyle modifications (reducing alcohol, managing stress, treating sleep apnea)
Catheter ablation if AFib continues to recur
Watchman device for long-term stroke prevention if blood thinners are problematic

Quick Facts

Procedure Time: 5-10 minutes
Sedation: Brief general anesthesia
Success Rate: ~90%
Recovery: Same day

Living with AFib?

If atrial fibrillation is affecting your quality of life, schedule a consultation to discuss your treatment options.