Electrical Cardioversion

Electrical cardioversion is a noninvasive procedure to treat an irregular heart rhythm caused by atrial fibrillation (AFib), atrial flutter or another type of arrhythmia. The procedure uses low-voltage electricity sent through paddles or patches on the outside of your chest to restore your normal heart rhythm.

When you choose UPMC for your electrical cardioversion procedure, you will receive expert care from some of Pennsylvania’s most experienced cardiac electrophysiologists specializing in the treatment of heart rhythm disorders.

What Is Electrical Cardioversion?

Electrical cardioversion uses paddles or patches attached to the outside of your chest to pass low-voltage electricity through your heart to restore your normal heart rhythm.

Types of Electrical Cardioversion

There are two types of electrical cardioversion:

• Non-emergency electrical cardioversion is performed to treat heart rhythm disorders and reduce the risk of related complications.
• Emergency electrical cardioversion to treat sudden, life-threatening heart rhythm problems.

Conditions we treat with electrical cardioversion

• Atrial fibrillation
• Atrial flutter
• Atrial tachycardia
• Ventricular fibrillation
• Ventricular tachycardia

Why Would I Need Electrical Cardioversion?

Electrical cardioversion can return your heart rhythm to normal if you are diagnosed with arrhythmia.        

Who’s a candidate for electrical cardioversion?

Your doctor may recommend electrical cardioversion if:

• You are having severe symptoms of an abnormal heart rhythm, such as shortness of breath, fatigue, or chest discomfort.
• Medications to treat your abnormal heart rhythm are not working.
• You are at high risk of heart attack, stroke, or another complication.

Alternatives to electrical cardioversion

• Catheter ablation.
• Chemical cardioversion using medication.
• MAZE procedure.
• Medication.

What Are the Risks and Complications of Electrical Cardioversion?

Although most patients do not have any side effects from electrical cardioversion, some people may develop skin redness and a sunburn-like feeling where the patches were placed. In rare cases, your provider may prescribe an ointment to treat irritated skin.

Other potential risks and complications include:

• Developing another type of abnormal heart rhythm.
• Increased risk of stroke due to blood clots.
• Low blood pressure.
• Temporary heart damage or heart failure.

How serious is electrical cardioversion?

Electrical cardioversion is a noninvasive procedure, and serious complications are rare. Emergency electrical cardioversion is a life-saving procedure to treat a serious abnormal heart rhythm.

Because electrical cardioversion involves your heart, it is essential to follow all of your doctor’s instructions to reduce the risk of problems.

What Should I Expect From Electrical Cardioversion?

Before: How to prepare for electrical cardioversion

Your doctor will explain the electrical cardioversion procedure to you and give you a chance to ask questions. To prepare for an electrical cardioversion, you should:

• Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
• Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
• Tell your doctor if you have heart valve disease, as you may need to receive an antibiotic before the procedure. 
• Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. It may be necessary to stop some of the medications prior to the procedure.
• Fast for a certain period of time prior to the procedure. Your doctor will tell you how long to fast (usually overnight).
• Have any tests that your doctor recommends. For example, your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot.

On the day of your electrical cardioversion procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.

Most people who have electrical cardioversion are discharged the same day. You will need to arrange for a ride home and should not drive for 24 hours after your procedure.

How long does electrical cardioversion take?

Electrical cardioversion takes about 10-20 minutes. However, you will need to remain in the hospital for several hours after the procedure so your care team can monitor your heart rhythm. Some people may need to stay in the hospital overnight.

During your electrical cardioversion

A member of your care team will place an intravenous (IV) line to deliver medication that puts you to sleep. Large patches covered in sticky gel will be placed on specific areas of your chest. You will be given oxygen through your nose.

Your medical team will monitor your heart rate, blood pressure, breathing, and blood oxygen level during the procedure. While you are asleep, your medical team will use a special machine to deliver the electric shock through the patches on your chest. Sometimes, more than one shock is necessary to restore normal heart rhythm. 

Are you awake during cardioversion?

You will get medication through an IV that puts you to sleep during your electrical cardioversion procedure.

Is electrical cardioversion painful?

Because you will be asleep during your electrical cardioversion procedure, you will not feel any pain.

Recovery after electrical cardioversion

You will remain in the hospital for several hours after the procedure, or possibly overnight if you are starting new medication. A nurse will check your blood pressure frequently and you will have an electrocardiogram to make sure your heart rhythm is normal.

After you are discharged, you can probably return to your normal routine soon. However, you should ask your doctor when you can return to work and exercise. Your doctor may also prescribe blood thinners to prevent blood clots and stroke.

You will be instructed not to drive for 24 hours after your procedure, so you will need to arrange for someone to drive you home. It is very important that you see your doctor for follow-up visits as recommended.

When to call your doctor about complications

You should call your doctor if you are experiencing any unusual symptoms, including:

• Burning or pain in your chest.
• Difficulty breathing.
• Difficulty swallowing, throat pain, or bloody cough.
• New or increasing shortness of breath.
• Rapid or pounding heartbeat.
• Redness or rash on your chest.

What’s the prognosis of electrical cardioversion?

Most people’s heart rhythm returns to normal after electrical cardioversion. However, some people may still need to take their heart rhythm medications. A small number of people may need to have another procedure in the future if their abnormal heart rhythm returns.

What’s the success rate of electrical cardioversion?

Electrical cardioversion has a success rate of up to 90 percent, depending on the type of arrhythmia you have. Your doctor will discuss potential success rates with you before your procedure.

Why Choose UPMC for Electrical Cardioversion?

Our heart rhythm experts perform hundreds of electrical cardioversion procedures each year using the latest technology and techniques. If you require additional cardiovascular care, the specialists at UPMC have the skills and experience needed to perform advanced cardiovascular procedures and offer you the latest treatment options.

By UPMC Editorial Staff. Last reviewed on 2024-10-01.