What is Cardioversion Therapy

Cardioversion therapy effective solutions to manage and correct abnormal heart rhythms. One such treatment is cardioversion therapy a quick and often highly successful procedure that helps restore the heart’s normal rhythm. Whether you’re newly diagnosed with an arrhythmia or exploring treatment options for a loved one, understanding cardioversion can help you make informed decisions about your heart health.

Cardiovascular diseases are among the leading causes of mortality worldwide. Among them, abnormal heart rhythms or arrhythmias can seriously disrupt the normal functioning of the heart. One of the most effective treatments to correct these abnormal rhythms is cardioversion therapy.

What is Cardioversion Therapy?

Cardioversion is a medical procedure used to restore a normal heart rhythm in people who have certain types of abnormal heartbeats (arrhythmias). It is commonly performed when the heart beats too fast or irregularly, especially in conditions like atrial fibrillation (AFib), atrial flutter, and supraventricular tachycardia (SVT).

The goal of cardioversion is to reset the heart’s electrical signals so that it beats normally. This can be done either through medications (chemical/pharmacologic cardioversion) or by delivering controlled electric shocks to the heart (electrical cardioversion).

Why is Cardioversion Therapy Done?

Cardioversion is typically recommended when the heart rhythm problem :-

1. Causes troubling symptoms such as palpitations, shortness of breath, fatigue, or chest discomfort

2. Increases the risk of blood clots or stroke

3. Cannot be managed effectively with medications alone

Common Conditions Treated with Cardioversion :-

1. Atrial Fibrillation (AFib) :- The most common irregular heartbeat, which can lead to stroke if untreated.

2. Atrial Flutter :- Similar to AFib but with a more organized rhythm.

3. Supraventricular Tachycardia (SVT) :- Rapid heartbeat arising from the upper chambers of the heart.

Types of Cardioversion Therapy

There are two main types of cardioversion :-

Electrical Cardioversion (Synchronized Cardioversion)

This involves delivering a low-energy, synchronized electric shock to the chest while the patient is sedated. The shock is timed with the heart’s rhythm to avoid causing further arrhythmias. It’s usually a quick, outpatient procedure with immediate results.

Key Points :-

1. Requires short-acting anesthesia or sedation

2. Shock is delivered through paddles or patches placed on the chest

3. Instant correction of abnormal rhythm in most cases

Pharmacological (Chemical) Cardioversion

In this method, antiarrhythmic medications are used to restore the heart’s normal rhythm. These drugs can be given orally or intravenously. While it’s non-invasive, it may take hours or even days to see results.

Common Medications Used :-

1. Amiodarone

2. Flecainide

3. Propafenone

4. Dofetilide

How to Prepare for Cardioversion Therapy?

Proper preparation is crucial for the safety and success of the procedure. Here’s what typically happens before cardioversion therapy :-

• Pre-Procedure Testing

1. ECG (Electrocardiogram) :- To confirm the type of arrhythmia

2. Blood Tests :- To check for electrolyte imbalances or thyroid issues

3. Echocardiogram :- To assess heart function and rule out blood clots

4. Transesophageal Echocardiogram (TEE) :- May be performed before cardioversion to ensure there are no clots in the heart, especially the left atrium

• Anticoagulant Therapy

If you’ve had an arrhythmia like AFib for more than 48 hours, your doctor will likely prescribe blood thinners like warfarin or direct oral anticoagulants (DOACs) for at least 3 weeks before and 4 weeks after the procedure to reduce the risk of stroke.

• Fasting and Medication

You’ll be asked not to eat or drink for several hours before the procedure. Your doctor will also provide instructions on whether to continue or pause certain medications.

What to Expect During Electrical Cardioversion?

The Procedure :-

1. You’ll lie down on a hospital bed or procedure table

2. Monitoring equipment will track your heart rhythm, oxygen levels, and blood pressure

3. Sedation will be given through an IV to make you sleep and feel no pain

4. Sticky electrode pads will be placed on your chest and sometimes your back

5. A synchronized electrical shock is delivered through the electrodes

6. The shock briefly stops your heart’s abnormal rhythm, allowing it to restart normally

The entire process takes about 10–30 minutes, including preparation and recovery.

What Happens After Cardioversion?

After the procedure :-

1. You’ll be monitored for a few hours

2. You may feel a bit groggy or have minor skin redness where the pads were placed

3. In most cases, patients go home the same day

Your doctor will likely prescribe antiarrhythmic medications to help maintain the normal rhythm. You may also be advised to continue anticoagulation therapy depending on your stroke risk (assessed using the CHA₂DS₂-VASc score).

Risks and Complications of Cardioversion

Cardioversion is generally a safe and well-tolerated procedure. However, like any medical treatment, there are potential risks :-

Common Side Effects :-

1. Skin irritation or burns from electrode pads

2. Temporary low blood pressure

3. Fatigue or muscle soreness

Rare but Serious Complications :-

1. Stroke due to dislodged blood clots

2. New or worsening arrhythmias

3. Adverse reaction to sedation or medications

4. Heart damage (extremely rare)

Your healthcare team will take every precaution to minimize these risks.

Success Rate of Cardioversion

The success of cardioversion depends on various factors including :-

1. Type and duration of arrhythmia

2. Underlying heart conditions

3. Age and overall health

Electrical cardioversion has a success rate of 70–90% in restoring normal rhythm, especially for atrial fibrillation or atrial flutter. However, there’s a chance the abnormal rhythm could return, especially without long-term management.

Lifestyle After Cardioversion: How to Prevent Recurrence?

To keep your heart rhythm stable post-cardioversion therapy, doctors recommend :-

• Regular follow-ups :- To monitor heart rhythm and adjust medications
• Blood thinners :- As prescribed to reduce stroke risk
• Heart-healthy lifestyle :-

• 1. Eat a balanced diet low in salt and fat

  2. Exercise regularly

  3. Avoid excessive caffeine or alcohol

  4. Quit smoking

• Manage underlying conditions:- Like high blood pressure, diabetes, or sleep apnea

When to Seek Immediate Medical Help

Contact your doctor or visit the emergency room if you experience :-

1. Sudden chest pain

2. Difficulty breathing

3. Fainting or dizziness

4. Rapid or irregular heartbeat returning

These could be signs of recurring arrhythmia or complications that need prompt attention.

Conclusion

Cardioversion therapy is a powerful and commonly used procedure to correct abnormal heart rhythms and restore a stable, healthy heartbeat. Whether electrical or pharmacological, cardioversion can significantly improve symptoms and quality of life for people suffering from conditions like atrial fibrillation or atrial flutter.