Cardioversion is a non-invasive procedure (no incisions required / small puncture / low to moderate sedation) where an electrical shock is delivered to the heart to convert, or change, an abnormal heart rhythm (arrhythmias) back to normal. There are two kinds of cardioversion: Pharmacological and electrical. Pharmacologic (chemical) cardioversion is when your doctor gives you one or more medicines to bring back your regular heartbeat. Electrical cardioversion is when your doctor restores your heart rhythms by sending an electrical shock to the heart. The type of procedure chosen will vary according to your particular health condition.

Cardioversion is also used in emergency situations to correct an abnormal rhythm when it is accompanied by faintness, low blood pressure, chest pain, difficulty breathing, or loss of consciousness.

Some patients who require a cardioversion procedure already have a pacemaker or implantable cardioverter defibrillator (ICD). Several precautions are necessary when attempting external cardioversion in a patient with a permanent implanted device. Cardioversion can change the settings of the ICD or pacemaker, or may damage the ICD or pacemaker, the leads, or the heart's tissue. Your doctor will take special precautions to lower the risk of damage.

Do you have a question? Request more information and we will connect you with an RWJBarnabas Health cardiovascular expert.

How to Prepare for the Procedure

Prior to a cardioversion, your doctor and treatment team will explain to you what to expect before, during, and after the procedure and potential risks of the procedure. Talk to your doctor about:

  • All medications, herbal products and dietary supplements you are currently taking and ask for their recommendations about each.
  • Diabetes and how to adjust your medicine on the day of the procedure.
  • Radiation exposure, especially for those that are pregnant.
  • Any allergies to medicines, latex, tape, iodine, and anesthetic agents.
  • Any history of bleeding disorders.
  • Any implanted device (e.g. pacemaker or ICD).
  • Any body piercings on your chest or abdomen.

Other recommendations include:

  • Eat a normal meal the evening before the procedure. However, do not eat, drink or chew anything after midnight before your procedure. If you must take medications, only take them with sips of water.
  • Leave all jewelry at home.
  • Remove all makeup and nail polish.
  • Wear comfortable clothing when you come to the hospital.
  • If you normally wear dentures, glasses, or hearing devices at home, plan to wear them during the procedure.

What to Expect Before the Procedure

Before the procedure, your doctor might perform a variety of tests, including:

What to Expect During the Procedure

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An electrical cardioversion usually takes 30 minutes. The procedure is usually performed in the cardiac catheterization lab. Check with your doctor about the details of your procedure. In general:

  • You will change into a hospital gown.
  • A nurse will start the intravenous (IV) line in your arm which will administer a sedative that will make you sleepy.
  • Your doctor will deliver an electrical shock through two paddles. One is placed on your chest and the other on your back. Or both paddles can be placed in the front of your chest. The shocks last less than a second.
  • After the shock has been administered, your doctor will check to see if your heartbeat is regular. Some people only need 1 shock, others may need more.
  • Once the heartbeat is restored to its normality, the procedure is complete.

What to Expect After the Procedure

After the procedure, you will be able to go home. However, you'll need to spend at least an hour in a recovery room after the procedure is finished. A nurse will monitor your vital signs and possible complications.

General Guidelines

  • You will have some redness or soreness on your chest that lasts for a few days.
  • You will need someone to drive you home, and your ability to make decisions may be affected for several hours after your procedure.
  • Your doctor will give you instructions to follow during your recovery.

Do you have a question? Request more information and we will connect you with an RWJBarnabas Health cardiovascular expert.

Cooperman Barnabas Medical Center
94 Old Short Hills Road
Livingston, NJ 07039
(973) 322-5000
Monmouth Medical Center
300 Second Avenue
Long Branch, NJ 07740
(732) 222-5200
Clara Maass Medical Center
1 Clara Maass Drive
Belleville, NJ 07109
(973) 450-2000
Community Medical Center
99 Highway 37 West
Toms River, NJ 08755
(732) 557-8000
Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
Jersey City Medical Center
355 Grand Street
Jersey City, NJ 07302
(201) 915-2000
RWJ University Hospital Rahway
865 Stone Street
Rahway, NJ 07065
(732) 381-4200
RWJ University Hospital Somerset
110 Rehill Avenue
Somerville, NJ 08876
(908) 685-2200
RWJ University Hospital Hamilton
1 Hamilton Health Place
Hamilton, NJ 08690
(609) 586-7900
Robert Wood Johnson University Hospital
1 Robert Wood Johnson Place
New Brunswick, NJ 08901
(732) 828-3000
Monmouth Medical Center Southern Campus
600 River Avenue
Lakewood, NJ 08701
(732) 363-1900

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