Atrial Fibrillation: Should I Try Electrical Cardioversion?

Decision Point

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Atrial Fibrillation: Should I Try Electrical Cardioversion?

Get the facts

Your options

  • Have electrical cardioversion.
  • Don't have cardioversion. Try other treatments to restore a normal heart rhythm and relieve symptoms.

Key points to remember

  • Cardioversion can return your heart to a normal rhythm. This helps relieve symptoms of atrial fibrillation.
  • For most people, cardioversion restores a normal heart rhythm right away. But atrial fibrillation often comes back. Many factors affect how long the heart stays in a normal rhythm. Your doctor can help you understand how well cardioversion might work for you.
  • Cardioversion is just one way to treat atrial fibrillation.
  • If atrial fibrillation returns after this procedure, you may try cardioversion again or you can choose another treatment.
  • Cardioversion does have some risks. These range from minor burns from the patches to a stroke or a dangerous abnormal heartbeat. Your doctor can help you weigh your personal risks against the possible benefits of cardioversion.
  • No matter what treatment you choose, it's important to take steps to prevent a stroke, manage other health problems, and have a heart-healthy lifestyle.
FAQs

What is electrical cardioversion?

Normally, the heart has a strong, steady beat. That beat is controlled by the heart's electrical system. Sometimes the system misfires, causing an irregular heart rhythm (arrhythmia). In atrial fibrillation, the heart's upper chambers quiver (fibrillate). The lower chambers beat without a regular rhythm and may beat too fast. This may cause symptoms, such as feeling dizzy, tired, or short of breath. It also can make you more likely to have a stroke.

Electrical cardioversion is one treatment option to try to stop atrial fibrillation and keep it from returning. It can also relieve symptoms of atrial fibrillation.

First, you'll get medicine through a vein to block pain and make you sleepy (IV sedation). Then a doctor will put patches on your chest or on your chest and back. After you are sedated enough, the patches deliver a brief electric shock to your heart. This resets your heart rhythm.

You may take rhythm-control medicines (antiarrhythmics) before and after cardioversion. This can make it more likely that your heart rhythm will return to normal and stay there. You will likely take a blood-thinner medicine (anticoagulant) to prevent blood clots before and after the procedure. This medicine lowers your risk of a stroke.

How well does cardioversion work?

For most people, cardioversion restores a normal heart rhythm right away. But atrial fibrillation often comes back. Normal rhythm may last less than a day or for weeks or months. How long it lasts depends on a few things. These include how long you've had atrial fibrillation, what's causing it, and whether you have another heart problem. Taking antiarrhythmic medicines can help you stay in a normal rhythm longer.

Your doctor can help you understand how well cardioversion might work for you.

If your atrial fibrillation returns, talk with your doctor about your next treatment options. You may choose to have cardioversion again. Or your doctor might recommend a different treatment, such as catheter ablation or medicines to control your heart rate or rhythm.

No matter what treatment you choose, it's important to take steps to prevent a stroke, manage other health problems, and have a heart-healthy lifestyle.

What are the risks of cardioversion?

Cardioversion does have some risks. For example:

  • You may have minor burns on the skin where the patches were placed.
  • Some people have a reaction to the sedation medicine given before the procedure.
  • Antiarrhythmic medicines used before and after this treatment may cause a dangerous irregular heartbeat. The cardioversion itself may also cause this.
  • Cardioversion might dislodge a blood clot in your heart. This could cause a stroke. Taking a blood thinner before and after the cardioversion can lower the risk of a stroke.

Your doctor can help you weigh your personal risks against the possible benefits of cardioversion.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Try cardioversion Try cardioversion
  • Cardioversion is done in a hospital. You'll get medicine to make you sleepy. You will not feel any pain.
  • Cardioversion itself takes about 5 minutes. But the whole procedure, including recovery, may take a few hours.
  • You may take rhythm-control medicines and a blood-thinner medicine before and after cardioversion.
  • Cardioversion restores normal heart rhythm for most people. This can relieve symptoms of atrial fibrillation.
  • Redness that looks and feels like a sunburn where the patches were placed.
  • Reaction to the sedation medicine.
  • Dangerous irregular heartbeat.
  • Stroke.
Don't have cardioversion Don't have cardioversion
  • You may decide to try other treatments to relieve symptoms, such as catheter ablation or medicines to control your heart rate or rhythm.
  • These treatments may help relieve symptoms.
  • They depend on the treatment you choose. Catheter ablation has some risks, including bleeding and bruising. Medicines may cause side effects, such as feeling tired or dizzy. Your doctor can explain the risks and side effects of these treatments.

Personal stories about cardioversion

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I was just diagnosed with atrial fibrillation. I decided to have cardioversion to see if it stops the unhealthy rhythm for a while.

Raymond, age 45

I didn't even know I had atrial fibrillation until my doctor found it during a physical examination. I have a couple of friends who went through a lot to get back to a normal rhythm, and it just seemed like too much trouble and then it didn't even work. Since I am not having symptoms, I think I will just take the medicines to control my heart rate and prevent strokes and not worry about it.

Tom, age 61

I had a cardioversion a long time ago, and it worked for a good while. I don't like the symptoms I'm having now, so I'm going to try cardioversion again.

Margarita, age 82

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to try cardioversion

Reasons not to try cardioversion

The idea of having a brief electrical shock doesn't bother me.

The idea of having a brief electrical shock worries me.

More important
Equally important
More important

My symptoms bother me a lot.

I don't have symptoms, or they don't really bother me.

More important
Equally important
More important

I'm comfortable having a procedure.

I'm not comfortable having a procedure.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having cardioversion

NOT having cardioversion

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1, Will cardioversion get your heart to a normal rhythm for good?
2, Are there other ways to relieve my symptoms of atrial fibrillation?

Decide what's next

1,Do you understand the options available to you?
2,Are you clear about which benefits and side effects matter most to you?
3,Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
2, Check what you need to do before you make this decision.

3. Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision 

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts 

Key concepts that you understood

Key concepts that may need review

Getting ready to act 

Patient choices

What matters to you 

Print Summary

Credits

Credits
AuthorHealthwise Staff
Primary Medical ReviewerRakesh K. Pai MD, FACC - Cardiology, Electrophysiology
Primary Medical ReviewerE. Gregory Thompson MD - Internal Medicine
Primary Medical ReviewerMartin J. Gabica MD - Family Medicine
Primary Medical ReviewerAdam Husney MD - Family Medicine
Primary Medical ReviewerJohn M. Miller MD, FACC - Cardiology, Electrophysiology
Primary Medical ReviewerHeather Quinn MD - Family Medicine
Primary Medical ReviewerStephen Fort MD, MRCP, FRCPC - Interventional Cardiology
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Atrial Fibrillation: Should I Try Electrical Cardioversion?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Have electrical cardioversion.
  • Don't have cardioversion. Try other treatments to restore a normal heart rhythm and relieve symptoms.

Key points to remember

  • Cardioversion can return your heart to a normal rhythm. This helps relieve symptoms of atrial fibrillation.
  • For most people, cardioversion restores a normal heart rhythm right away. But atrial fibrillation often comes back. Many factors affect how long the heart stays in a normal rhythm. Your doctor can help you understand how well cardioversion might work for you.
  • Cardioversion is just one way to treat atrial fibrillation.
  • If atrial fibrillation returns after this procedure, you may try cardioversion again or you can choose another treatment.
  • Cardioversion does have some risks. These range from minor burns from the patches to a stroke or a dangerous abnormal heartbeat. Your doctor can help you weigh your personal risks against the possible benefits of cardioversion.
  • No matter what treatment you choose, it's important to take steps to prevent a stroke, manage other health problems, and have a heart-healthy lifestyle.
FAQs

What is electrical cardioversion?

Normally, the heart has a strong, steady beat. That beat is controlled by the heart's electrical system. Sometimes the system misfires, causing an irregular heart rhythm (arrhythmia). In atrial fibrillation, the heart's upper chambers quiver (fibrillate). The lower chambers beat without a regular rhythm and may beat too fast. This may cause symptoms, such as feeling dizzy, tired, or short of breath. It also can make you more likely to have a stroke.

Electrical cardioversion is one treatment option to try to stop atrial fibrillation and keep it from returning. It can also relieve symptoms of atrial fibrillation.

First, you'll get medicine through a vein to block pain and make you sleepy (IV sedation). Then a doctor will put patches on your chest or on your chest and back. After you are sedated enough, the patches deliver a brief electric shock to your heart. This resets your heart rhythm.

You may take rhythm-control medicines (antiarrhythmics) before and after cardioversion. This can make it more likely that your heart rhythm will return to normal and stay there. You will likely take a blood-thinner medicine (anticoagulant) to prevent blood clots before and after the procedure. This medicine lowers your risk of a stroke.

How well does cardioversion work?

For most people, cardioversion restores a normal heart rhythm right away. But atrial fibrillation often comes back. Normal rhythm may last less than a day or for weeks or months. How long it lasts depends on a few things. These include how long you've had atrial fibrillation, what's causing it, and whether you have another heart problem. Taking antiarrhythmic medicines can help you stay in a normal rhythm longer.

Your doctor can help you understand how well cardioversion might work for you.

If your atrial fibrillation returns, talk with your doctor about your next treatment options. You may choose to have cardioversion again. Or your doctor might recommend a different treatment, such as catheter ablation or medicines to control your heart rate or rhythm.

No matter what treatment you choose, it's important to take steps to prevent a stroke, manage other health problems, and have a heart-healthy lifestyle.

What are the risks of cardioversion?

Cardioversion does have some risks. For example:

  • You may have minor burns on the skin where the patches were placed.
  • Some people have a reaction to the sedation medicine given before the procedure.
  • Antiarrhythmic medicines used before and after this treatment may cause a dangerous irregular heartbeat. The cardioversion itself may also cause this.
  • Cardioversion might dislodge a blood clot in your heart. This could cause a stroke. Taking a blood thinner before and after the cardioversion can lower the risk of a stroke.

Your doctor can help you weigh your personal risks against the possible benefits of cardioversion.

2. Compare your options

 Try cardioversionDon't have cardioversion
What is usually involved?
  • Cardioversion is done in a hospital. You'll get medicine to make you sleepy. You will not feel any pain.
  • Cardioversion itself takes about 5 minutes. But the whole procedure, including recovery, may take a few hours.
  • You may take rhythm-control medicines and a blood-thinner medicine before and after cardioversion.
  • You may decide to try other treatments to relieve symptoms, such as catheter ablation or medicines to control your heart rate or rhythm.
What are the benefits?
  • Cardioversion restores normal heart rhythm for most people. This can relieve symptoms of atrial fibrillation.
  • These treatments may help relieve symptoms.
What are the risks and side effects?
  • Redness that looks and feels like a sunburn where the patches were placed.
  • Reaction to the sedation medicine.
  • Dangerous irregular heartbeat.
  • Stroke.
  • They depend on the treatment you choose. Catheter ablation has some risks, including bleeding and bruising. Medicines may cause side effects, such as feeling tired or dizzy. Your doctor can explain the risks and side effects of these treatments.

Personal stories

Personal stories about cardioversion

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I was just diagnosed with atrial fibrillation. I decided to have cardioversion to see if it stops the unhealthy rhythm for a while."

— Raymond, age 45

"I didn't even know I had atrial fibrillation until my doctor found it during a physical examination. I have a couple of friends who went through a lot to get back to a normal rhythm, and it just seemed like too much trouble and then it didn't even work. Since I am not having symptoms, I think I will just take the medicines to control my heart rate and prevent strokes and not worry about it."

— Tom, age 61

"I had a cardioversion a long time ago, and it worked for a good while. I don't like the symptoms I'm having now, so I'm going to try cardioversion again."

— Margarita, age 82

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to try cardioversion

Reasons not to try cardioversion

The idea of having a brief electrical shock doesn't bother me.

The idea of having a brief electrical shock worries me.

       
More important
Equally important
More important

My symptoms bother me a lot.

I don't have symptoms, or they don't really bother me.

       
More important
Equally important
More important

I'm comfortable having a procedure.

I'm not comfortable having a procedure.

       
More important
Equally important
More important

My other important reasons:

My other important reasons:

  
       
More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having cardioversion

NOT having cardioversion

       
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Will cardioversion get your heart to a normal rhythm for good?

  • Yes
  • No
  • I'm not sure
That's correct. Although cardioversion may return your heart to its normal rhythm, atrial fibrillation often returns.

2. Are there other ways to relieve my symptoms of atrial fibrillation?

  • Yes
  • No
  • I'm not sure
That's right. There are other treatments to relieve your symptoms, such as catheter ablation or medicines to control your heart rate or rhythm.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

     
Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

 
Credits
ByHealthwise Staff
Primary Medical ReviewerRakesh K. Pai MD, FACC - Cardiology, Electrophysiology
Primary Medical ReviewerE. Gregory Thompson MD - Internal Medicine
Primary Medical ReviewerMartin J. Gabica MD - Family Medicine
Primary Medical ReviewerAdam Husney MD - Family Medicine
Primary Medical ReviewerJohn M. Miller MD, FACC - Cardiology, Electrophysiology
Primary Medical ReviewerHeather Quinn MD - Family Medicine
Primary Medical ReviewerStephen Fort MD, MRCP, FRCPC - Interventional Cardiology
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