Cardioversion success

What is “cardioversion”?

Cardioversion is a outpatient procedure where they “shock” your heart back into rhythm……

I have seen documentaries done in Vancouver General in Vancouver, British Columbia, where a young woman in novel AF was taken in and cardioverted. However, unlike the typical cardioversion we're talking about here, with the administration of propofol, maybe a smattering of fentanyl for pain (that was my experience), and then up to three consecutive shocks, each with increasing joules, hers was different. They explained to her that they would first stop her heart....cold...wait-two-three...and then do the cardioversion resumption of her heartbeat. She was discharged a few minutes later beaming.

Over four separate instances of AF, I was cardioverted with the simple procedure. The first time, no reversion to NSR. The second, third, and fourth times, each lasted 16 hours, 4 hours, and 20 minutes respectively. The point is that whether-or-not they work depends on your heart's current state, or its morphology. Different patients have different issues inside their hearts, different extents of fibrosis, or different foci for re-entrant and looping current that makes the various chambers beat out of sync. For some, but especially early in their AF history, a cardioversion works well and may even be permanent. For others, it may only work for a few days or even hours, maybe months, but their hearts are evolving and will find another path for the re-entrant focus, a new one....bang, you're back in AF, of flutter, or SVT, or whatever.

Cardioversion is a hopeful resort to restore NSR. I believe, despite my own personal history over four attempts, that it can, and DOES, work for some. I cannot give you any percentage because I simply don't know. It's always worth a try because if it works, great, and it's a 30 minute procedure (including the post-zap monitoring to ensure stability in your rhythm), whereas an ablation is much more involved. In my case, I couldn't wait for an ablation, and was only too glad to be finally given the nod. It took two swings at my heart, but the second ablation did the trick.

Thanks: Appreciate the information……

My husband hasn't been diagnosed but I believe he has AFIB. His heart beat is super strong and his blood pressure fluctuates up and down as high as 200 one night (it just happens at night when he lays down to go to bed). His heart beat is so strong he can feel his heart beat down to his feet. Hes type 2 diabetic and has had 2 heart attacks. His legs have both had plaque removed by his heart doctor. He cannot sleep in bed, has to be a chair. Someone please help.
651-494-4787
I have never been on this site before but he needs help now.
Thank you.
Rae

Your primary doctor can diagnose AFIB very quickly…. Get it checked out ASAP….. He may need a blood thinner immediately….

He needs to be assessed, yesterday. He either must go to an ER if his primary doctor is not available, and be hooked up to both a cuff and to an ECG to record his heart rate and rhythm. Or, he should be given an implantable Loop Recorder, or made to wear a Holter Monitor for probably 48 hours, depending on what his heart is doing and if they don't see anything on the ECG.

Yes, probably an anti-coagulant, but that will be determined by a physician such as a cardiologist or an electrophysiologist. His other circumstances, including current prescriptions, may mean that he cannot be administered an anti-coagulant.

Excellent advise……in my experience any medical professional ( ER OR URGENT CARE) can initially diagnose AFIB. To be confirmed later by EKG. My local doctor immediately gave me Eliquis. Sometimes actually getting an appointment with a cardiologist is time consuming….

What is cardioversion?

Cardioversion is an electrical reset of the heart's SA node (sino atrial node, from where the electrical impulse for the four chambers to beat issues. The patient is attended to by an ER physician, a nurse, and often by an RT (respiratory therapist to monitor your breathing while the procedure is undertaken...you'll be unconscious.) You will possibly be given adenosine to slow the heart rate and to reveal the nature of the arrythmia that is being depicted on a concurrent ECG. That part of the experience is not fun, but it's over inside of 12 seconds or so (I can explain this if anyone is interested). Once the true nature of the arrhythmia is established (ie that it is truly AF and not flutter), they'll now how to place the shock paddles and sensors. Then, you are given propofol in your IV that was inserted when you presented to the ER and were taken inside. You'll be gone inside of 20 seconds, usually, although I have a funny story about that. Then, while you're out, they can shock your heart only three times, each time raising the joules to increase the jolt if your heart stays in arrythmia. About two minutes later, you come to and hopefully you can hear the welcome beap, beap, beap and everyone is smiling.

In summary, it is a series of shocks while you are unconscious gratis a propofol, the same stuff they administer for endoscopy, trans-esophageal echocardiograms, and for colonoscopy procedures. If one of the three shocks works, you're out of the ER and on the way home after a short period of observation, maybe 30 minutes to an hour on your back.