Why do I need this?

Your heart has constant irregular beats (Atrial Fibrillation or Atrial Flutter).

What is cardioversion?

An electrical charge will be passed through your chest using two pads.                   This will try to:

  • return the heartbeat to normal
  • improve how your heart works if it is not normal
  • reduce the chance of long term complications

Up to 4 attempts can be made on the day to restore the normal rhythm. The frequency and severity of an irregular heartbeat can improve if you exercise regularly. It also helps to keep a BMI of 27 or below. Restrict any alcohol to the recommended guidelines (4 units per week for an irregular heartbeat). Ideally avoid it completely. With your GP manage the following conditions as well as possible:

  • high blood pressure
  • obstructive sleep apnoea
  • high cholesterol
  • diabetes
Is it painful?

You will be given a short acting general anaesthetic so you will have no memory of it. It only lasts several minutes. You may have some itching or a little redness to your chest after. If this is uncomfortable it can be eased with after sun, moisturising cream or simple pain relief like paracetamol if needed.

Will I be allowed home after?

You will usually be allowed home shortly after you have recovered. In the unlikely event that you do not recover well enough to go home, or if you will be alone at home, you may have to stay overnight. Please drink plenty of fluids after and do not do any exercise, driving or use machinery for 48 hours.

Advice after an anaesthetic

An anaesthetic can harm your ability to drive. You must make arrangements to be driven home after. You must not drink alcohol or use machinery.

Should I attend if I am unwell?

If you get any fever / illness / infection before please telephone the Cardioversion Secretary 01228 814194

Information relating to COVID 19:

In line with local and national guidance DO NOT attend any face to face appointment if:

  • you or a member of your household has had COVID 19 type symptoms
  • you or a member of your household has tested positive in the last 14 days
What will happen on the day?

The Cardiology Specialist Nurse will assess you first. You will then be seen by the Anaesthetist. They will assess you for the anaesthetic. You will be asked to change into a gown. Please bring a dressing gown and slippers with you. You will then wait to be called in.

A nurse will take 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. When you are “unconscious” the procedure will be done.

You will wake up in the recovery room. You will then be taken to the day surgery recovery area. You will be given hot drinks and a snack. When the nurses are happy with your recovery you will be allowed to dress. You will then wait to see the Cardioversion Doctor.

A Cardiology Consultant or cardiology specialist nurse will see you before you go home. They will tell you if it was successful. They will also advise which medication to continue or stop using. They will arrange a follow up or further treatment.

Will it be successful?

Immediate success rate is at least 50-80%. It is possible that the heart will return to an irregular rhythm in the first few hours after.  If this happens it may be best to consider another cardioversion on another day. Some patients may be offered other treatments or medications as an alternative.

Is it safe?

There are always risks with any anaesthetic or cardiac procedure. The risks of developing complications such as a stroke or heart attack are small. The nurse will tell you of any risks at your pre-assessment.

Why do I need to take an anti-coagulant?

An irregular heartbeat can develop blood clots. The blood clots can be dislodged and move causing stroke or heart attack. These risks are reduced if anti-coagulant is taken.

If you are prescribed warfarin, your INR must be within a therapeutic range for at least 3 consecutive weeks before. It is your responsibility to arrange INR checks and to tell the cardiology specialist nurse the results.

If you are prescribed one of the new anticoagulant medication (apixaban, rivaroxaban, edoxaban, dabigatran), these can be taken on the morning before 6:00am with a small amount of water. You will be asked to sign a form to say you have not missed any doses.

Patient checklist

Things to remember before your Elective DC Cardioversion:

  • Anticoagulation MUST be taken as prescribed without interruption for at least 4 weeks before.
  • INR (warfarin) MUST be above 2 for 3 consecutive weeks before. It is your responsibility to arrange regular INR checks.
  • Apixaban / Edoxaban / Rivaroxaban / Dabigatran must be taken as normal before.
  • You MUST have nothing to eat (nil by mouth) from 12 midnight. You can drink clear fluids up to 2 hours before (up until 7:00 am).  This can be water, juice without pulp and BLACK tea or coffee.
  • Inhalers should be taken.
  • Digoxin should be stopped 72 hours before.
  • Kidney (renal) function, full blood count, thyroid and liver function bloods test should be taken. Or taken within the last 3 months.
  • Men are advised to shave their chest.
  • You MUST have arranged transport to and from the hospital on the day. You should not use public transport.
  • Bring a small overnight bag with you in case you need to stay.

After your Elective DC Cardioversion:

  • Bring your medication into hospital. This can be taken after.
  • You must have someone at home with you overnight.
  • You should not to drive.
  • Do not do any extreme activity for at least 48 hours.
  • If you have any irritation to the skin use after sun lotion and pain relief if needed.
  • Keep well hydrated.

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