Harvard Heart Letter

Cardioversion for afib

Ask the doctor

Q. I am scheduled for an electrical cardioversion for my atrial fibrillation. What should I expect?

A. Electrical cardioversion is a procedure to convert a fast or irregular heartbeat (such as what happens with atrial fibrillation, or afib) to a normal rhythm. Before the procedure, your cardiologist may recommend a special ultrasound test of your heart to check for blood clots. Cardioversion may dislodge any clots, which can be life-threatening. So if clots are found, the procedure may be delayed for a few weeks, so you can take blood-thinning medications to lower your risk of complications such as stroke.

Before the cardioversion, you can't eat or drink for eight to 12 hours. You'll receive intravenous medications through a vein in your arm to make you sleepy throughout the procedure. A nurse or technician will place patches called electrodes on your chest. Wires from the electrodes connect to a cardioversion machine. This machine (also called a defibrillator) records your heart rhythm and delivers low-energy shocks that help restore your heart to a normal, steady rhythm. After you're sedated, the procedure only takes a few minutes. But you'll stay in a recovery room for a few hours afterward and be monitored to make sure you don't develop any complications. You'll need to have someone drive you home.

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