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Cardioversion Q&As

Published by Bupa's health information team, November 2008.

Answers to questions about cardioversion

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

Why do I need anticoagulant medicines before having a cardioversion?

You will usually be prescribed anticoagulant medicines to help reduce your risk of developing a blood clot.

Explanation

If you have an arrhythmia it means you have an abnormal heart beat. Because of this, blood may start to pool in the chambers of your heart and form a clot. The blood clot can block circulation in your heart and cause a heart attack. If it moves through the bloodstream to the brain it could cause a stroke.

Your doctor will usually prescribe anticoagulant medicine (usually warfarin) to help reduce your risk of developing a blood clot. You will usually be asked to take this for at least three weeks before, during and for at least four weeks after having cardioversion.

Further information

Sources

  • Atrial fibrillation - guidance 36. National Institute for Health and Clinical Excellence (NICE). June 2006. www.nice.org.uk, accessed 8 April 2008
  • Sulke N, Sayers F, Lip GYH. Rhythm control and cardioversion. Heart 2007; 93:29-34. www.bmj.com, accessed 8 April 2008
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Why do I need medicines to help regulate my heart rhythm after cardioversion?

Medicines to help regulate heart rate and rhythm are usually prescribed if cardioversion doesn't work or the arrhythmia comes back after a previous treatment.

Explanation

Arrhythmia can return within a few minutes or in the first two weeks of a successful cardioversion. Sometimes it can re-occur later than two weeks.

Studies suggest cardioversion is more likely to succeed and arrhythmia is less likely to re-occur if antiarrhythmia medicines such as amiodarone and sotalol are used. Antiarrhythmia medicines help control the heart rate and rhythm.

You are more likely to have antiarrhythmia medicines if the cardioversion hasn't worked or if your arrhythmia returns after a previous attempt.

These medicines are not used routinely with a first cardioversion attempt because of their side-effects. However, your doctor may recommend using them if he or she thinks the cardioversion is likely to fail. For example, cardioversion is more likely to fail if you have had arrhythmia for a long time.

Further information

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Is there a limit to how many times you can have cardioversion for arrhythmia?

You are likely to be offered a second cardioversion treatment if your arrhythmia returns after a previous successful procedure. If your arrhythmia returns again, your doctor is likely to suggest alternative treatments to correct your arrhythmia.

Explanation

It's possible that the cardioversion may fail to correct your heart rhythm. It's also possible that the arrhythmia may return within a few minutes or in the first two weeks of a successful cardioversion. Sometimes it can re-occur later than two weeks.

Research suggests cardioversion may be attempted again if a previous attempt has failed or if arrhythmia returns after a successful procedure.

You are likely to be offered a second cardioversion treatment if your arrhythmia returns after a previous successful procedure. With your second treatment, your doctor will most likely prescribe medicines to help control your heart rhythm to avoid a further relapse.

If your arrhythmia returns again, your doctor is likely to suggest alternative treatments to correct your arrhythmia.

Further information

Sources

  • Atrial fibrillation - guidance 36. National Institute for Health and Clinical Excellence (NICE). June 2006. www.nice.org.uk, accessed 8 April 2008
  • Sulke N, Sayers F, Lip GYH. Rhythm control and cardioversion. Heart 2007; 93:29-34. www.bmj.com, accessed 8 April 2008
  • Adgey AAJ, Walsh SJ. Theory and practice of defibrillation: (1) Atrial fibrillation and DC conversion. Heart 2004; 90:1493-1498. www.bmj.com, accessed 8 April 2008
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Related topics

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr Tim Cripps DM, FRCP, Consultant Cardiologist, specialist in electrophysiology, Bristol Royal Infirmary, and by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: November 2008.

 

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