First Electro Cardioversion

[Bayonnejoe]

I am anticipating my first electro Cardioversion (aka the paddles). I have a question. What are the risks? In particular, what are the chances of a clot being thrown out of the heart? I have been on Apixaban for about 2 years. Do they do a heart ultra sound prior to CV to see if any clots are present? I'm anxious because I've had an AFib stroke. I know what another could do. Also since I've just moved from proximal AF to permanent. This is new territory for me. Thanks in advance for any help.

[Kaz747]

When I had an emergency cardioversion for atrial flutter they did a TOE first (transoesophageal echocardiogram) to make sure there were no clots. I was then put on anticoagulants for 4 weeks afterwards. This was a few months before I was diagnosed with AF and put on anticoagulants permanently. I’m not sure what they do when you’re having a planned cardioversion but there’s plenty of people on this site who have been through it that can tell you.

[Shcldavies]

There is a change of blood clots moving around thankfully the Docs know about this and to prevent this happening carry out some checks prior to the procedure and but you on medication to prevent it happening. I have not heard of any problems when these precautions have been done. You will be pleasantly surprise with the procedure, the most unpleasant part is the wait and the blood clot checks. There is a small risk that it will not work and they may then revert to drugs which I understand are not very pleasant but this risk is very small.

[Bagrat]

I understand your concerns in your circumstances. If/when you have signed a consent form they should go through the risks in your specific case and considering your history will do all necessary checks.

Cardioversion is not an arduous procedure but neither is it usually a long lasting "cure," though my friend's OH has had no episode since his a couple of years ago.

[BobD Volunteer]

I won't lie and say no risk at all but the staff are well versed in dealing with any problems and you are in the right place should anything occur. Anticoagulation such as Apixaban should ensure that there are no clots to fly but if you have missed any doses then make sure that you tell the team so they can do a TOE (the ultrasound thing ) to check.

[Bolander]

I also had a TOE prior to a cardioversion that has kept me in normal rhythm for two years. The procedure itself is done under sedation so you should wake up to find it's all over.

[Tapanac]

The first time I had a cardio version I had a scan behind my heart to check no blood clots lurking and then had the treatment as I wasn't on any anti-coagulants. No problem. That was 2 years ago. I then had an ablation although I was doing fine on flecainide and bisoprolol, but my EP wanted me off the flecainide which I understand could cause other arrhythmias.

However this week I went into tachycardia/atrial fibrillation and had to have an emergency cardio version yesterday. As I had been on Apixaban for nearly 2 years and didn't have any break from it until October when I had a foot operation, the hospital didn't worry about the scan.

I don't know for sure as I was sedated (albeit for about a minute), but I believe a cardioversion is more done with electrics not the de-febrillator type paddles???? I know I was all wired up and with oxygen, but I saw no sign of any paddles.

I can assure you it is entirely painless and hopefully successful and today I even had friends round for lunch. So no worries. Good luck.

[Hidden]

They will put you to sleep charge your heart and wake you up taking no more than 10 minutes. It's safe but not as effective as an Ablation, so dont have too high an expectation it may only last a few days or weeks at best