Home > Electrical Cardioversion for Atrial Fibrillation
Electrical cardioversion is a procedure in which an
electric current is used to reset the heart's rhythm back to its regular
pattern (normal sinus rhythm). The low-voltage electric current
enters the body through metal paddles or patches applied to the chest wall.
Cardioversion is used:
Before cardioversion for atrial fibrillation, you will be
given medicine to control pain and cause relaxation.
You may take
an anticoagulant medicine, such as warfarin, for a few weeks before and a few weeks after cardioversion. How
long you take anticoagulants will depend on how long you had atrial
fibrillation before the cardioversion procedure.
You might not need to take anticoagulants before the procedure if you have a low risk of stroke. For example, if a test,
transesophageal echocardiogram, has ruled out the
presence of blood clots in the upper heart chambers (atria), you will not need
anticoagulants before the procedure. But you will still need to take
anticoagulants for at least a few weeks after cardioversion, even if no clots were
Additional medicines to help prevent the return of heart
rhythm problems (antiarrhythmics) also may be given before and after the
procedure. Your risk of having atrial fibrillation again is greater if
antiarrhythmics are not used after cardioversion.
cardioversion, you will be monitored to ensure that you have a stable heart
Cardioversion is used as an
emergency procedure when symptoms of very low blood pressure, chest pain, or
heart failure caused by rapid, irregular atrial fibrillation are
Cardioversion also is used in nonemergency situations to
stop atrial fibrillation and return the heart rhythm to normal.
For help deciding if you should have electrical cardioversion, see:
The success of electrical
cardioversion depends on how long you have had atrial fibrillation and what is
causing it. Cardioversion is less successful if you have had atrial
fibrillation for longer than 1 year.
treatment, about 9 out of 10 people get back a normal heart rhythm right away. But for many people, atrial fibrillation returns. About 3 to 5 out of 10 people still have a normal heart rhythm 1 year after cardioversion.1 Normal rhythm may last less
than a day or for weeks or months. It depends on your other health
Staying in a normal rhythm is more likely when the
cause of your rhythm problem is not heart disease. But for most people, atrial
fibrillation is caused by heart disease and is very
likely to return.
If your atrial fibrillation returns, you may be able to have
cardioversion again. But if the problem comes back quickly (within a week or
so), having the treatment yet again is less likely to help you.
antiarrhythmic medicines too, they can help you stay
in a normal rhythm longer.
Risks of the procedure include the
Cardioversion may be less
successful or may not be recommended if you:
Cardioversion is more likely to be successful if:
Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.
Morady F, Zipes DP (2012). Atrial fibrillation: Clinical features, mechanisms, and management. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 825–844. Philadelphia: Saunders.
November 2, 2010
E. Gregory Thompson, MD - Internal Medicine & John M. Miller, MD, FACC - Cardiology, Electrophysiology
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