Electrical and chemical cardioversions are two types of procedures available to treat atrial fibrillation. The goal of both types of cardioversions is to convert the heart to a normal heart rate (normal sinus rhythm).
Electrical Cardioversion for Afib
Electrical cardioversion is a controlled electric shock that’s used to return your heart beat to normal. You may be somewhat familiar with the process simply because it’s portrayed on TV so often, but don’t let those TV scenes scare you. The procedure is nothing like you see on TV. It’s not nearly as dramatic.
Doctors apply a pair of patches to your chest area and administer the electric shock. The shock only happens for a few seconds, and you will be under anesthesia and unconscious the whole time.
I have had 4 electrical cardioversions to date myself! I can assure you that while it sounds scary and looks painful when you see those scenes on TV, it really isn’t a big deal. It’s a quick and painless procedure. Having said that, it’s not something that’s terribly fun either. After all, who likes to go to the E.R. to be sedated and shocked?
Here is what an electrical cardioversion looks like in real life. The gentleman in this video was being cardioverted after an episode of afib. He has since had an ablation and has been afib free since.
During an electrical cardioversion, all of the electrical activity in your heart is stopped momentarily, allowing your heart to hopefully return to a normal sinus rhythm. I say “hopefully” because for some atrial fibrillation patients, electrical cardioversions don’t work. Instead of the heart returning to a normal heart rhythm, it continues to beat irregularly.
This procedure is non-invasive, painless, and one of the safest short-term treatments for atrial fibrillation.
The one question many patients have, myself included, is how many of these can you have done before it becomes dangerous? After all, you would think having multiple “mini electrocutions” would be harmful for you after a while. I have asked a few cardiologists and they have all told me there are no long-term affects as far as they know. And that’s the thing, nobody really knows right now. I have had 4 myself and so far it doesn’t appear I have suffered any long-term damage. I know of another afib patient who has had 11 without any problems.
While electrical cardioversions are relatively safe and effective, they are a short-term treatment. You don’t want to treat afib constantly with cardioversions. If you are in afib on a regular basis and you don’t respond to drugs or don’t tolerate them, you’d be better off talking to your doctor about an ablation instead of having regular cardioversions.
So far I have had an afib episode about once a year so having an electrical cardioversion once a year is just an inconvenience for me for now. However, if my episodes star occurring in a shorter time frame, I’ll definitely be scheduling an ablation.
Chemical Cardioversion for Afib
Chemical cardioversion, also called a pharmacological cardioversion, is a procedure where you are given anti-arrhythmic drugs in an attempt to convert your heart to normal sinus rhythm. If you are in the E.R. because of an afib episode, they will usually try to convert you first via a chemical cardioversion. The drugs are typically administered via an I.V.
If the drugs don’t convert your heart to normal sinus rythm, then they’ll typically do an electrical cardioversion so both types of cardioversions are often done during your visit to the E.R.
While electrical and chemical cardioversions are relatively safe and effective in the short-term, they are just that – short-term solutions. As I’ve mentioned, if you’re having multiple cardioversions done, then you should talk to your doctor about a more effective long-term solution such as a catheter ablation.