FREMANTLE HOSPITAL & HEALTH SERVICE

Department of Cardiology - Testing Unit

Elective Cardioversion

An elective cardioversion is a simple procedure where an electrical shock is delivered to the heart to convert an abnormal heart rhythm back to a normal rhythm.  It is performed under a light, general anaesthetic. 

Most elective or “non-emergency” cardioversions are performed to treat benign heart rhythm disturbances such as atrial fibrillation or atrial flutter that originate in the upper chambers of the heart. 

Pre Procedure 

Blood tests that include serum urea, electrolytes and INR (if on Warfarin) need to be done prior to your cardioversion.  If you are taking the drug Digoxin, those levels will also need to be checked.  Your GP should fax the blood test results to the Cardiac Catheter Theatre office the day prior to the procedure. 

On the morning of your procedure, you will need to arrive at Fremantle Hospital at 7.00am, having fasted from midnight.  

You enter the hospital through the main entrance, which is located on Alma Street, and report to the Enquiries Counter.  From there you will be directed to the Admissions area where you will have your admission paperwork performed before being escorted by an orderly to the Same Day Unit (SDU). 

In the SDU, a nurse will need to complete a checklist including details of your past medical history, when you last ate and drank, your blood pressure, heart rate and weight and what medications you are taking.  You will be asked if you have any allergies to food and/or drugs and an identification band will be put on your wrist.  You will then be asked to change into a hospital gown, your dressing gown and slippers.   You will also need to give the name and telephone number of a relative or friend who will drive you home post procedure. 

The procedure will then be explained to you by a Resident Medical Officer (RMO) and once informed, you will need to sign a consent form. 

A device (bung) will be inserted into a vein in your hand for the delivery of intravenous drugs and fluids and an ECG will be done to ensure you are still in an irregular rhythm. 

The Procedure 

You will be transferred from the SDU to the Cardiac Catheter Theatre (CCT) via stretcher.  

A nurse in CCT will check your identification band, ask when you last ate and drank and whether you are wearing dentures.

In theatre you will be connected to a cardiac monitor and defibrillation pads will be applied to you chest and back.  Your blood pressure, heart rate, respirations and oxygen saturation will also be monitored throughout the procedure. 

An Anaesthetist will be in attendance to administer sedation and monitor your airway and breathing.  You may be asked to remove your dentures prior to defibrillation. 

Once you are asleep, cardioversion (defibrillation) is performed.  You may need more than one shock to revert your abnormal rhythm back to a normal rhythm.  

Once awake, you will be transferred to the Recovery Area where your vital signs will be monitored for 30 minutes or until you are fully responsive.   

A repeat ECG will then be done.  The RMO will inform you as to whether the procedure has been successful and what your on going treatment will involve. 

You will be transferred back to the SDU for another 2 hours to fully recover prior to discharge. 

Discharge 

You will be discharged on the same day as the procedure and given a Patient Discharge Pamphlet that outlines the precautions you need to be aware of post cardioversion. 

It is important that you don’t drive a car or operate machinery for 24 hours after receiving an anaesthetic.  You therefore need a family member or friend to drive you home and stay with you that night.  

Be aware that it is normal to experience some chest soreness following the cardioversion.  You may also notice a burning pain similar to sunburn.  The regular use of an anaesthetic cream is recommended to relieve the pain. 

If you experience any of the following symptoms after discharge, it is important to immediately present to the closest Emergency Department: 

·          Angina (chest pain)

·          Difficulty breathing

·          Dizziness

·          Palpitations (irregular heartbeat)

·          Unusual fatigue and/or weakness 

General Information 

If you have any questions or concerns following discharge, please telephone: 

Same Day Unit on 9431 3234 - Monday to Friday 6:30am - 7:30pm   (not public holidays or Christmas period) 

Cardiac Catheter Theatre on 9431 2991 - Monday to Friday 8:30 am to 4:30pm   (not public holidays or Christmas period) 

or your General Practitioner

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