Cardioversion elective

Overview

Elective cardioversion is a planned medical procedure that uses a controlled electric shock to restore a normal heart rhythm in people who have an irregular heartbeat, such as atrial fibrillation. It is done in a hospital setting, usually under sedation, to help the heart beat regularly again.

Yes, elective cardioversion is a common procedure for people with atrial fibrillation or other heart rhythm problems.

It mainly affects adults, especially those over 60, and people with heart conditions such as high blood pressure, heart failure, or valve disease.

Symptoms

Common symptoms

• Palpitations – feeling like your heart is racing, fluttering, or pounding
• Shortness of breath
• Fatigue or weakness
• Dizziness or lightheadedness

Symptoms in children

• Palpitations or a sensation of the heart beating irregularly
• Difficulty feeding or poor growth in infants
• Fatigue during play or activity

Symptoms in older adults

• Shortness of breath with mild activity
• Confusion or feeling faint
• Chest discomfort or pain

Causes

Main causes

• Atrial fibrillation – the most common reason for cardioversion
• Atrial flutter – a fast but regular rhythm in the upper heart chambers
• Other types of supraventricular tachycardia (fast rhythms starting above the ventricles)

Risk factors

• Older age (over 60)
• High blood pressure
• Heart disease, such as coronary artery disease or heart valve problems
• Obesity
• Diabetes
• Excessive alcohol use or binge drinking

When to see a doctor

See a doctor urgently if:

• If you have chest pain, severe shortness of breath, or feel like you might faint, call your local emergency number immediately.
• If you have a fast or irregular heartbeat that does not settle down within a few minutes

Book a routine appointment if:

• If you notice persistent palpitations, fatigue, or dizziness that interfere with daily life
• If you have been diagnosed with atrial fibrillation and want to discuss treatment options like cardioversion

Diagnosis

Your doctor will typically diagnose the irregular heart rhythm using an electrocardiogram (ECG), which records the electrical activity of your heart. You may also have other tests to check the structure of your heart and your risk of blood clots.

Tests that may be done

• Electrocardiogram (ECG) – quick and painless test to check heart rhythm
• Echocardiogram (ultrasound of the heart) – to see heart structure and function
• Blood tests – to check thyroid, kidney, and electrolyte levels
• Holter monitor or event monitor – a portable ECG worn for 24 hours or longer to catch intermittent rhythm problems

What to expect at your appointment

If your doctor recommends elective cardioversion, you will have a visit beforehand to discuss the procedure, medications, and any risks. On the day of the procedure, you will be given sedation, then a small electric shock is delivered through paddles or patches on your chest. It usually takes only a few seconds. You will be monitored for a few hours afterwards before going home.

Treatment

The main treatment for restoring a normal rhythm is elective cardioversion. Before the procedure, most people are given blood-thinning medicine for several weeks to reduce the risk of stroke. The procedure itself is done in a controlled hospital setting with sedation. Afterward, you may continue blood thinners and possibly rhythm-control medication to help maintain a regular heartbeat.

Self-care at home

• Take all prescribed medicines exactly as your doctor tells you
• Avoid alcohol and heavy meals before the procedure
• Arrange for someone to drive you home after the sedation wears off
• Rest for the remainder of the day and avoid heavy lifting or driving

Medical treatments

Medical treatment before and after cardioversion often includes blood-thinning medications to prevent clots, and medications to control heart rate or help maintain a normal rhythm. Your doctor will choose the best medicines based on your health needs. In some cases, an injection of a medicine through a vein can also be used to try to convert the rhythm without electricity.

When is surgery considered?

If cardioversion does not work or the irregular rhythm returns, your doctor may discuss other procedures such as catheter ablation (a procedure that destroys tiny areas of heart tissue causing the abnormal rhythm) or pacemaker implantation. These are considered when medicines and cardioversion are not effective.

Living with this condition

After elective cardioversion, most people feel better because their heart rhythm returns to normal. However, you may need to continue taking medications and have regular check-ups. If the irregular rhythm returns, you and your doctor can discuss repeating the procedure or other options.

Lifestyle tips

• Limit or avoid alcohol and caffeine, which can trigger palpitations
• Quit smoking – it greatly reduces your risk of heart rhythm problems
• Manage stress with relaxation techniques like deep breathing or meditation
• Get enough sleep and avoid extreme fatigue

Diet and exercise

A heart-healthy diet (rich in fruits, vegetables, whole grains, and lean protein) along with regular moderate exercise, such as walking, swimming, or cycling, can help maintain heart health. Always check with your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Living with an irregular heartbeat can cause anxiety or worry about your health. It is normal to feel this way. Talking with your doctor or a counselor can help. Many people find relief once the rhythm is restored and they know what to do if symptoms return.

Prevention

While you cannot always prevent the underlying heart condition, you can lower your risk by controlling high blood pressure, maintaining a healthy weight, limiting alcohol, and managing stress. If you already have an irregular rhythm, taking prescribed medications can help prevent recurrence.

Vaccines

There are no vaccines specifically to prevent arrhythmias. However, staying up-to-date with recommended vaccines (including flu and pneumonia) can help prevent infections that might worsen heart conditions.

Screening programmes

Routine screening for irregular heartbeat is not typically done for everyone. Your doctor may check your pulse at regular check-ups. If you have risk factors or symptoms, an ECG may be recommended.

Complications

If left untreated

• Increased risk of stroke if atrial fibrillation is not treated with blood thinners
• Worsening heart failure symptoms due to an uncontrolled fast heart rate
• Chronic fatigue and reduced quality of life

Long-term outlook

For most people, elective cardioversion is a safe and effective way to restore normal rhythm and improve symptoms. Even if the irregular rhythm returns, many people can have repeated procedures or explore other treatments. With proper medical care and lifestyle changes, the outlook is generally good.

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