just wondering if anyone can give some tips prior to cardioversion. Am just waiting to have one (.when I don’t know?..)… but thought to ask others if there are any things that they did or were advised to do before the procedure. Hope it’s not a daft question… just trying to think how I can give it my best shot.
query re cardioversion : just wondering... - Atrial Fibrillati...
query re cardioversion
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JFJ131
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I've had several and can assure you there's nothing to a cardioversion and the following is what I've experienced.
You go to the hospital, sit around waiting for about an hour for your turn. You go in, get undressed and put on one of their gowns. You lie on a bed and someone comes and puts a cannula in the back of your hand and you're wired up to a machine that's showing your heart rate. You have largish pads put on your chest and sometimes back. The team turn up all bright and happy (doc and some nurses). You have the sedation (which knocks you right out) injected into your cannula, are zapped and then wake up a few minutes later and for me I'm always back in normal sinus rhythm. The feeling of joy is like no other and gratitude to everyone involved sweeps over me - honestly I could kiss their feet! You can sometimes get red marks on your skin under the pads where you were given the shock(s). I believe you can have up to three of those but I always went back into AF after the first one.
At my hospital they want you to eat some toast and have a cup of tea before leaving, that's it! They tell you that you need to have someone to drive you home and be with you for the next 24hrs and are told not to sign any documents during that time.
A word of warning though. Afterwards don't do anything that requires exertion for a week or so, no walking up hills, or lifting anything heavy. Allow your heart to gain strength beating at it's correct rate. I once made the mistake of walking up a hill the day after a cardioversion and my heart went straight back into AF. Oh, no overeating or alcohol for a while after either.
I cant remember anything special I had to do before the procedure but when I had mine you needed to have been taking anticoagulants for 4 weeks beforehand.
Best wishes
Jean
Very kind of you to set out the procedure so comprehensively…thank you Jean. Best wishes to you
Thanks for this advice . I too am waiting for my first cardio version and found this very reassuring.
Was told to stay off of supplements 10 days before cadioversion,
One was magnesium because I was a drunk and drinking deplete magnesium, I think it might of helped as I was told, it was very close and doc had thought he normalized beat, but was made it was not successful. I feel now, going off magnesium was a mistake to lose the conductor.
Hi Mike, sorry to hear that. I am surprised you were told to stay off magnesium. I do take that too, and understand it is very important for the heart. Hope you have another planned..and have success. best wishes
Having had 28 cardioversions, the best bit of advice I can give you is not to worry ! Otherwise I think Jean has covered it all. ( I don't know about the toast business though 🤔😅....
Best wishes & Good luck
J
I have had 5 cardioversions. I think the most important thing to do is ask the anaesthetist to use fentanyl in the sedative and make sure to ask him/her to tell you when the fentanyl is injected. Seriously the whole procedure is over before you know it.
thanks for the tip. best wishes
I'm not sure that an anaesthetist would appreciate being told what drugs to use !!!😬
yes.... it would have to be gently brought up for sure.... more of a question i guess....
I did use the word “ask” 😉😉. In South Africa they are generally quite obliging.
Yes, I know jonathan…appreciate that. You are right … we should be able to ask, raise things. Anyone worth their salt would not actually get defensive eh…
Thanks again
I agree that we should be able to ask before any procedure or operation - in fact ideally they’d tell us what they are planning to use, as a matter of course, when they explain the procedure.
I’ve had a cardioversion (which was exactly as Jean so helpfully described - but no tea and toast for me!) and as I was going in, I asked what drugs they were using. The very nice anaesthetist said he uses a mix of sedation, anaesthetic and anti nausea, but didn’t seem to want to clarify exactly what. It was a “don’t worry your pretty little head about that, I’ll look after you” type attitude! (In a kindly way, not superior or defensive.)
I only wanted to know because I’m allergic to some things and I figured that if I survived whatever they used, I’d know I could have it another time!
Good luck with your cardioversion - I was really nervous but it was the easiest of procedures to be on the receiving end of. And the euphoria of a regular heartbeat afterwards is a feeling like no other! Jx
Hi Jonathan, I’m really intrigued about the fentanyl - can I ask why you’d give this advice? Thank you! Jx
It is very effective at calming your nerves and puts you in a good space. An anaesthetist will you give just the right amount.
More importantly - back to the original post … cardioversions are very quick and after 5 having of them myself can’t think of anything you can do to prepare for it or make it go smoother.
Thanks for your tips…much appreciated. Best wished
…wishes…
Ah thank you Jonathan, I’ll be sure to ask if they’re using fentanyl for any future procedures! I’m pretty sure I’ve been given some for a gastroscopy. 
if you've been in AF more than a couple of days they usually perform a TOE first which is a fine scope down yr oesophagus, it can check your heart out but more importantly it checks to see if any clots have started forming, its an ultra sound. Once they confirm you are clear they give you the CV. This is synchronised to time in with your heart so the zap is much lower than the shock you see in the movies. I've had 3 and 2 times i was back in rhythm first time and the other occasion it was 3 zaps. I think they started that one at 70 joules of energy which is low. I felt fine once the sedation wore off. I took it easy for a few days no lifting nothing requiring effort for a couple of weeks. Its a straight forward procedure and you should be fine.
I would read about breathing properly so if you do feel anxious you can breath it away. My go to book is Breath by James Nestor its an interesting read about how we have forgotten how to breath properly
Many thanks for the reply and tips James. I did not realise they do the TOE .... does not sound nice. Presume they do this whilst under the anaesthetic? hope so. best wishes to you.
Yes the TOE is very straightforward maybe ask them abt it, they gave me some sedation and said count to 10 and I got to 3, next thing I woke up in recovery! I also was out on Flecainide a week before and told it gives the CV a better chance to work first time
I also did blood tests later that month and found I was low in Vitd3, magnesium and coq10. I’ve been supplementing since.
I'm in the UK and I've had about 10 cardioversions and not once did I have a TOE. I guess the longest I ever waited for a cardioversion was almost 2 months. They were once going to do one right away when I went to A&E, that was do it without any sedation whatsoever. I can tell you I reverted to normal rhythm as they were setting it up and my was I happy! The power of the mind is amazing.
Aye.. ..I can understand that…lol
The TOE part sounds worse than what it is. You literally won't recall having to do this part and they explain it to you beforehand as you will be probably under twilight for that.
I've had two cardioversions that were not successful at keeping me in sinus rhythm. It happens quickly and they know quickly if it worked. After some months, they were able to do a successful cyro ablation that has kept me in rhythm since 2018. Even the ablation was not as bad as it sounds when they explain it.
Best of luck! It'll be okay.
TOE is not a standard procedure, prior to cardioversion in the UK, If its elective, as in JFJ's case, you are just required to ensure that you are continously anticoagulated for at least 3 weeks prior.
A TOE would only normally be done if it was an urgent cardioversion and you had not had anticoagulants.
Perhaps it's different in OZ.
Don't worry. I went for a check with my Cardiologist during which he said I was in AFib (I'm pretty asymptomatic)His rooms are at a hospital and I had got my son to take me as the parking is so bad. He asked if I would like a Cardioversion, I said since I'm here I may as well. I was admitted, had the procedure in the afternoon, knew nothing about it, was given a sandwich and a cup off coffee and off I went (I had phoned my son to tell him to go away and come back when I phoned). I made absulutely no preparation for it !
oh...sounds good. Can i ask - when was this and was it successful? - hoping so.
It was 6 years ago, it was one zap and back in NSR - I have had a few short episodes since with very few symptoms, but I go to the Cardio annually, have a check and echo and I have always been in NSR when he checks me and my heart has not changed . I go to my GP for new prescriptions every six months ( I am still on the usual - anti coagulant and I take 1.25mg of Biso, but only when I think my HR is rising at rest) - I take it if my HR is in the 90s - I think I'm one of these Vegus Nerve people, my HR seems to rise if I eat too heavy a breakfast - oats or something like that. So now I stick to banana in plain yoghurt with a tiny bit of soaked nut and seeds muesli or a croissant and jam!
Your breakfast sounds lovely lol. Another question, if you dont mind. Why do you have an Echo every year....and is that usual for us with AF?
I live in South Africa and use private medicine, so I like to go annually for a roadworthy - but I don't think it's essential, just from choice.He needs the money , no government subsidy for doctors other than those who work in the Public hospitals and that is the minority😀
It’s good to make breathing exercise a regular practice (I found box breathing invaluable for any stray ectopics) and relaxation/meditation using my Balance app was a constant go-to prior and after ablation. The heart, and healing generally, responds well to low stress. Also check out anti inflammatory diet, especially avoid high processed food, sugar and additives. Walk, cycle and public transport kept me (and the planet!) fitter than using a car. But my real bible was the patient advice sheets here on Afib forum or website.
Mine's on Wednesday. They've sent me a 12 page patient guide booklet.
Just make sure you turn up 😀
The worrying and waiting are far worse than the actual procedure, which is less stressful then a visit to the dentist in my opinion. I came out thinking "well that was easy!", And I'd have another any time.
If you're lucky enough to wake up to the regular beeps of sinus rhythm on the monitor a few minutes later, you may even find that part uplifting!
I’m in a similar position to you so really appreciate the replies you got to the question. Thanks . 🙏🙏
yes...the support on this site/forum is amazing. All such nice people - taking the time to share experiences. Thanks to all from me too!
What Jean said, and rest rest and rest. And read the indepth A4 recycled going home sheet.
Had one a few days ago, my first was 20 years ago , lasted 10 years,(had a nother due to alcohol "holiday afib" in that time, next 5, next 3, next 2 , now this one, it shows the progression, biting the bullet for ablation next I think, I promise you the procedure is of course nervy but afterwards you will understand why people say it's a doddle, fully agree with resting up a bit even if to just gain a bit of self confidence, I work physically in construction, and normally used to give myself just a day or so rest. But this time a week, mainly as the meds they've now put me on has lowered my rate and BP a bit too much , you can take faith from others story's and try to learn your triggers for the future , good luck
many thanks for your reply. So…yours seems to always result positively which is great. Best wishes
Had dozens. Jean is spot on. Piece of cake.
Trust your medical professionals rather than thinking you can “do your own research” and can advise them!
Above all, relax and deep breathe and behave … haha.
For prior, just make sure you don't miss any anticoagulant for at least 3 weeks prior or they may well refuse to do it. There's not really anything else you can physically do to influence the outcome.
For after, would recommend that you have some Savlon or similar as you may get irritation from where they put the pads and make sure you take it easy for a few days.
Otherwise, you'll be fine and hopefully, back in NSR.
Good luck. 😊
I've had two and they were as easy as pie. For me, it was an extremely simple procedure. I was second in line before someone else had theirs done. I was put on a table, given an IV, I was out like a light, and woke up 5 minutes later in NSR. I had instructions to take it easy the rest of the day, and went home right after. I honestly had no side effects either. Wishing you luck for yours!
many thanks for your reply and good wishes.
hi, I’ve had two, v similar experience to jeanneannie. First was in COVID, in NHS hosp. The worst part was the wait in a made up seating area, for ten of us, quite public and a long wait. My second, in a private hosp, the private single rooms has v thin walls. After all six of us were done, you could hear the anaesthetist tell three people they were successfully cardioverted, the rest of us had to wait until the head nurse came round and broke the bad news! but we knew already🤣🤣
I was very tired afterwards and it lasted days or weeks depending on how.long.i was in (fast) AF. Some people feel great immediately apparently though. Best wishes
That’s for sharing .
A Cardioversion is like jump starting a vehicle, it gets you going but doesn’t fix the original problem.
It can indicate what your next treatments should be.
Thanks for your input. Would you mind explaining what routes of next treatments could be?
For me the next treatment was to prescribe a different beta blocker & rhythm regulator and 2 ablations.
Hope all worked well for you.
So far my treatment is working well.
Thanks for your input. Would you mind explaining what routes of next treatments could be?
Very practical tip. Take a wash bag and extra knickers with you. The electric shock can make you.........
Oh heck…. Many thanks for the tip though….
Best wishes
The first 2 cardioversions were fine, only the last one....
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For further information, please download the following booklet from the AF Association resources tab on the AF Assoc website: api.heartrhythmalliance.org...
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booklet
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Try not to get stressed about anything after cardio version either, I got emotional upset over my son and bang right back into AF with a vengeance just over 24 hrs after cardio version and I felt like Jean after I got cardio version I felt like ME again. They never give me another go . Said it wouldn’t work as I had an enlarged left ventricle but now I’ve been told by another cardiologist it’s enlarged left atrium and RVR latter I read in my medical notes 🤷♀️. Good luck I hope you get your cardio version soon
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