What is defibrillation and why has it been recommended?
Your heart has a persistent irregularity of rhythm called ATRIAL FIBRILLATION or ATRIAL FLUTTER. An electrical charge will be passed through your chest through two pads. This will attempt to return the rhythm to normal, improve the function of your heart and reduce the likelihood of complications in the long term. Three attempts (3 shocks) can be made to restore the normal rhythm.
Is the procedure painful?
You will have no recollection of the procedure as you will be given a short acting general anaesthetic, the whole procedure lasting only several minutes. Following defibrillation, you may experience some itching and redness of the skin on your chest, where the pads were placed. This is usually very mild and soothing creams are provided. Men are advised to shave the chest the night before to prevent redness. If you cannot manage to do so a nurse will do this for you.
Will I be allowed home after the procedure?
You will usually be allowed home shortly after you have recovered from the anaesthetic. In the unlikely event that you have not recovered sufficiently to return home or you have no one with you at home, it may be necessary to remain in hospital overnight.
Advise after an anaesthetic?
An anaesthetic can impair your ability to drive. You must make arrangements to be driven home from the Surgical Day Unit following the procedure. You must not drink alcohol or operate machinery.
What is the likelihood that the procedure will be successful?
Immediate success rate is at least 50-80%. There is a possibility that the heart will return to an irregular rhythm the in first few hours after the procedure, or at any time thereafter. If this does occur it may be appropriate to consider a further defibrillation on a separate occasion. Some patients may be offered other treatments or medications as an alternative.
Is it safe?
There are always risks associated with any anaesthetic or cardiac procedure although the risks of developing complications such as a stroke or heart attack are small. The nurse will advise you of any risks at your pre-assessment.
Why do I need to take an anti-coagulant?
The heart can develop blood clots whilst in the irregular rhythm. At any time (or after defibrillation) the blood clots can be dislodged and move causing stroke or heart attack. These risks are reduced if anti coagulation is taken. If appropriate the cardiology specialist nurse will ensure your INR results are within range 3 weeks leading up to your cardioversion.
If you are prescribed one of the new anticoagulant medication (apixaban, rivaroxaban, edoxaban, dabigatran) you will be asked to sign a form to confirm you have not missed any doses.
Are there any other precautions?
Please do not eat or drink from midnight the night before your cardioversion. You should have nothing to eat and drink on the morning of defibrillation except a small amount of water if necessary to take your tablets.
Do I need to alter my medication?
Take your medications as normal. The cardiology specialist nurse may advise you to alter your medication after the cardioversion.
Should I attend if I am unwell?
If you do develop any fever/illness/infection before the cardioversion, please telephone the Cardioversion Secretary 01228 814384
Information relating to COVID 19:
You will be advised nearer the time of your procedure about the latest guidelines relating to COVID 19.
DO NOT attend any face to face appointments if you or any member of your household has experienced COVID 19 type symptoms or have tested positive in the last 14 days.
What will happen on the day of Cardioversion?
On arrival, the Cardiology Specialist Nurse will assess you. You will then be seen by the Anaesthetist. He/she will assess you for the anaesthetic. You will be asked to change into a gown (please bring with you a dressing gown and slippers). You will then wait to be called for your cardioversion.
A nurse will escort you to the theatre room. In the theatre you will be met by the Anaesthetist and Cardiology specialist nurse. You will be given an anaesthetic and once sufficiently “unconscious” the cardioversion will take place.
You will wake up in the recovery room and then be taken to the day surgery recovery area. Here you will be given hot drinks and a snack. Once the nurses are happy with your recovery you will be allowed to dress and wait to see the Cardioversion Doctor.
A Cardiology Consultant or cardiology specialist nurse will see you before you go home. They will inform you if the cardioversion was successful. They will also advise which medication to continue or discontinue. They will arrange follow up or further treatment under the referring Consultant.
Confidentiality
‘The Trust’s vision is to keep your information safe in our hands.’ We promise to use your information fairly and legally, and in-line with local and national policies. You have a right to understand how your information is used and you can request a copy of the information we hold about you at any time.
For further information on confidentiality contact the Information Governance Team:
Information.Governance@ncic.nhs.uk | 01228 603961
Feedback
We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:
pals@ncic.nhs.uk | 01228 814008 or 01946 523818
If you would like to raise a complaint regarding your care, please contact the Complaints Department:
complaints@ncic.nhs.uk | 01228 936302