Cardiovert

Cardioversion is a medical procedure used to restore a normal heart rhythm in people with certain types of abnormal heartbeats, known as arrhythmias. The most common type of arrhythmia treated with cardioversion is atrial fibrillation, although it can also be used for atrial flutter, supraventricular tachycardia, and other types of fast heart rhythms from the upper parts of the heart. There are two main types of cardioversion: electrical and pharmacological.

Types of Cardioversion

Electrical Cardioversion

Electrical cardioversion involves the use of a short electrical shock to the heart, which is delivered through electrodes attached to the chest. The procedure is usually performed under short-acting anesthesia or sedation to ensure the patient does not feel pain. Electrical cardioversion is often considered when medication is ineffective in controlling the arrhythmia or when a rapid response is required.

Pharmacological Cardioversion

Pharmacological cardioversion, on the other hand, uses medications to restore normal heart rhythm. This approach may be preferred in patients who are not candidates for electrical cardioversion or in specific types of arrhythmias where medications have a high success rate. The choice of medication depends on the type of arrhythmia, the patient's overall health, and other factors.

Indications

Cardioversion is indicated for patients who suffer from symptomatic arrhythmias that negatively affect their quality of life or pose a risk to their health. The decision to proceed with cardioversion takes into account the duration of the arrhythmia, underlying heart condition, and the presence of any contraindications.

Procedure

Before undergoing cardioversion, patients typically undergo a series of tests, including electrocardiograms (ECG), echocardiograms, and sometimes blood tests. These tests help to confirm the type of arrhythmia and to identify any underlying conditions that may need to be addressed before the procedure.

For electrical cardioversion, the patient is sedated, and electrodes are placed on the chest. A controlled electrical shock is then delivered to the heart, which can reset the heart rhythm to normal. The procedure is usually quick, and patients can often go home the same day.

Pharmacological cardioversion involves the administration of antiarrhythmic drugs, either orally or intravenously, depending on the situation. The effectiveness of the medication is monitored through continuous ECG.

Risks and Complications

While cardioversion is generally safe, it carries some risks, such as skin burns from the electrodes, adverse reactions to the sedative or antiarrhythmic medications, and the potential for blood clots to form and cause a stroke. To minimize the risk of stroke, patients may be prescribed anticoagulants before and after the procedure.

Aftercare

After cardioversion, patients are monitored to ensure the heart maintains a normal rhythm. They may need to continue taking medication to prevent the arrhythmia from recurring and to manage any underlying heart conditions. Regular follow-up appointments with a healthcare provider are essential to monitor the patient's heart health.