Cardioversion uses an external defibrillator to return your heart to a normal rhythm.
First you are given a medicine that will relax you and control pain. Then a doctor places paddles or patches either on your chest or on your chest and back. These send an electric current to your heart. This resets your heart rhythm. The rhythm is more likely to return to normal and stay there if you also take antiarrhythmic medicines before and after this treatment.
Taking antiarrhythmic medicines alone—without electrical cardioversion—is another way to get back your normal heart rhythm. You may get pills, or the medicine may be put into your arm through an IV. If an IV is used, it will be done in the hospital. These medicines may not work as well as cardioversion. And they can have serious side effects.
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.1
After this treatment, about 9 out of 10 people get back into a normal heart rhythm right away.2 But for many people, atrial fibrillation returns. Normal rhythm may last less than a day or for weeks or months. It depends on your other health problems.
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 you might not stay in a normal rhythm for very long. If atrial fibrillation comes back quickly (within a week or so), having cardioversion a third time, or more, is less likely to help you. Your doctor might recommend a different treatment, such as medicine, to get your heart rhythm back to normal.
If you take antiarrhythmic medicines too, they can help you stay in a normal rhythm longer.
Having a stroke is the most serious risk. Cardioversion may dislodge a blood clot in your heart. This can cause a stroke. But you can lower this risk quite a bit by taking certain steps:
Cardioversion also has other risks:
If you choose not to try cardioversion, you still will be at risk for problems from atrial fibrillation, such as:
If your symptoms don't bother you a lot, your doctor may have you take medicines to slow your heart rate or control your heart rhythm.
You will still probably need to take an anticoagulant (also called a blood thinner) to lower your risk of stroke.
Your doctor may recommend this treatment if:
|Try cardioversion||Take medicines instead|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I am only 45 and I don't want to spend the rest of my life feeling tired, out of breath, and like I have butterflies in my chest. I've decided to try cardioversion one time, to see if it will fix my atrial fibrillation."
— Raymond, age 45
"I didn't even know I had atrial fibrillation until my doctor found it during a physical exam. 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
"Managing my heart failure has become more difficult since I developed atrial fibrillation. My doctor has encouraged me to try cardioversion, because she hopes it will help my heart work better and help me feel better."
— Manny, age 78
"I have other health conditions that I am managing well with medicines. I don't have any symptoms. So, taking another drug won't change my life."
— Margarita, age 82
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 an electrical shock doesn't bother me.
I'm scared at the idea of having an electrical shock.
My symptoms bother me a lot.
My symptoms don't really bother me.
I'm not worried about taking a drug that will put me to sleep during the procedure.
I don't like the idea of taking a drug that will put me to sleep.
I'd rather have cardioversion than take medicines for a long time.
I'd rather take medicines than have cardioversion.
I'm not worried about the risk of a stroke from cardioversion.
I'm worried about the risk of a stroke from cardioversion.
My other important reasons:
My other important reasons:
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.
NOT trying cardioversion
1. Does cardioversion work for everyone?
2. Will cardioversion get your heart to a normal rhythm for good?
3. Is there another way to treat atrial fibrillation?
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?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology|
|Specialist Medical Reviewer||John M. Miller, MD, FACC - Cardiology, Electrophysiology|
Fuster V, et al. (2011). 2011 ACCF/AHA/HRS focused update incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 123(10): e269–e367.
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.