Understanding a Cardioversion

I have seen so many questions about the cardioversion procedure on this and many other AF forums. From the questions I have seen, I don't think that Drs are doing a very good job of explaining what this is.

I have routinely seen the following statements:

"I had a cardioversion but it didn't work because I started AF again 2 months (insert timeframe here) later". OR "I have been scheduled for a cardioverson to see if it works before trying another treatment."

Drs are leaving patients with an idea that cordioversion is going to "fix" the AF. I don't think they mean to do that but are just not very good at explaining things.

Cardioversion - a medical procedure by which an abnormally fast heart rate (tachycardia) or cardiac arrhythmia is converted to a normal rhythm, using electricity or drugs. In most cases this will bring the heart back into NSR. In some cases of permanent or persistent AF the heart will still remain in AF (irregular beat) and will not respond to cardioversion.

Cardioversion is not meant to keep the heart in NSR. I you have AF when the next attack happens you will need to be cardioverted again (unless you normally convert on your own).

Think of it as having a dead battery in your car. Someone with a set of jumper cables (the cardioversion) hooks up your battery and shocks it to start your car. Did that fix your battery?

Nope, when you try to start your car again the battery is still bad and you'll need another jump (cardioversion) to start it again. You will continue to need that jump (cardioversion) until you replace the battery and fix the problem. The jumper cables were never intended to be a permanent fix just as the cardioversion is not intended to be a permanent fix.

In AF, your heart is out of rhythm and beating fast and cardioversion is intended to jump your heart to get it back into rhythm and slow it down But unless you do something like medicines or a procedure like ablation the heart will need to be jumped again with the next attack.

I honestly think the Dr is telling them what they are going to do to put the heart back into rhythm but not continuing on to explain that they will need other treatment to keep it from happening again. That cardioversion is only used to temporarily force the heart back into rhythm and is not intended to keep it there.

Again... I didn't mean to go on and on about this but I have seen so many with questions about cardiversion and expectations that they will be "fixed" with this procedure. I actually spoke to someone yesterday who was opting to not take anticoagulants because he was cardioverted 2 months ago in the hospital so he doesn't need blood thinners any longer. He just couldn't believe that this procedure didn't fix his heart. He said that his Dr said "we'll try the cardioversion and see what happens". Well since his heart went back into NSR it worked so he doesn't need the blood thinners now. I feel the Dr did a poor job of explaining what he was doing and what the outcome would be.

Hope I didn't bend your ears too much...

Tim

8 Replies

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  • Yeah, my ears are bleeding, Tim ;-) JUST KIDDING!!! You did a good job with the car battery analogy. It really hadn't occurred to me before that people were thinking the cardioversion is a fix. It is no more a fix than when I convert to NSR on my own....the AF will be back because the underlying problems still exists. Good job! Hope you are getting some springtime out there. Sun is finally out here with 80 degrees! Woo Hoo!

  • Hi SRM.. Right now we are in a bunch of storms and under a tornado watch.. The grass is growing very fast and because of the weather you can't mow it. Gonna have to buy some goats.

    Tim

  • We'll get your storms tomorrow...thanks :-( Looks like our grass won't get cut either. Our grass guy seems to be m.i.a. so maybe will look into the goats ;-)

  • Spring Grandma and 80 degrees? we don't get that in summer in the UK. :)

    Horribly jealous, it was about 45 today and strong winds,

    I am sure the sun would fix my AF, or if it didn't it would certianly make me feel better :)

    Ian

  • Don't be too jealous Ian, tomorrow we are expecting rainstorms with a high of 56. Crazy spring weather. Today was indeed a RARE spring day and our high was 85 ! Loved every second of it !

  • Good explanation - will show husband who has never really understood what I had done!!! Thanks

  • Good explanation. You are quite right the doctors never explain properly what they hope to achieve, and leave the impression that once kick started in NR things will be fine.

  • yoyo & derrylynne Thanks for the comments.

    derryltnne, That is exactly what I have heard from others. They understood (from their Dr) that once the cardioversion was done they were good to go and no more AF.

    Tim

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