Cardioversion. Exceptional healthcare, personally delivered

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1 Cardioversion Exceptional healthcare, personally delivered

2 This booklet is intended for use by patients and their families when preparing for a cardioversion. What is a cardioversion and how is it performed? Cardioversion is performed in hospital under a general anaesthetic. It is a procedure to treat an abnormal heart rhythm. The doctor will place electric paddles or sticky pads on your chest then send electrical energy to the heart through them. This energy is synchronised with your own heartbeat and if effective, returns your heart to its normal rate and rhythm. Cardioversion is usually done as a day case, so that you come to hospital and go home the same day. Occasionally it is necessary to stay overnight. Why do I need to have a cardioversion? You may have been having palpitations or an irregular heart beat for sometime. Your doctor may have prescribed a course of tablets e.g. Amiodarone, Digoxin, Atenolol or Verapamil to control your heart rhythm. These are not always successful and if your palpitations have been troubling you, causing chest pains, shortness of breath or reduced activity then further treatment is necessary. By restoring your heart s normal rhythm, symptoms can be improved. Will it be successful? There is a greater chance of success if you heart has only been in an abnormal rhythm for a short while, i.e. a few weeks or months. The effectiveness does vary from person to person. In most people (9 in every 10 people) the procedure will restore the normal regular heart rhythm initially, but, in a number of people the heart rhythm will revert to how it was, at a later 2 Cardioversion

3 date. In a few instances the procedure will not be successful at all. Depending on various factors, the likelihood of your heart staying in the normal regular Sinus Rhythm at 12 months is 5-6 in every 10 people. The best results are seen in patients who have normal heart structures. The lowest success rates are seen in patients with structural heart impairment, for example, leaky valves or enlarged heart chambers. Before you come into hospital We need to check that you are suitable to be treated as a day case. In most cases you will be seen by a pre-assessment nurse at the hospital before the actual procedure date. The nurse will talk to you, take a blood sample and ECG recording. They will need to make sure that you can get to and from the hospital as you will not be able to drive. As you will be having a general anaesthetic you must not have anything to eat or drink for at least six hours before your admission time. If you are taking Digoxin, you should stop taking it 48 hours before you come to hospital. If you are on medication you may take it on the morning of your admission with a small sip of water. If you are diabetic, the pre-assessment nurse will explain what you need to do before you come into hospital. Cardioversion 3

4 On arrival at hospital You will be seen by a nurse and a doctor who will talk about the procedure and be able to answer any questions you have. You will then be asked to sign a consent form to show that you are happy to proceed with treatment. The anaesthetist will talk to you about what will happen and ask you questions about your health and any allergies you may have. You will be attached to a cardiac monitor in order to record your heart rate. Staff will take your blood pressure and record your breathing rate. The anaesthetic will be given through a small needle in the back of your hand. The procedure takes about 5 minutes. You will then be taken to the recovery area. What happens next? You will sleep off the effects of the anaesthetic and wake up in your own time. When you wake up you will probably be lying on your side and wearing an oxygen mask. The nursing staff will monitor your blood pressure, heart rate and breathing rate. When you are fully awake you will be told how the procedure went and staff will be happy to answer any questions. Some people feel slightly sick after anaesthetic, but you will be given a drink and something to eat when you feel able to. When you have recovered, you will be given another ECG so that the doctor can see if the procedure has been successful. 4 Cardioversion

5 Providing you feel well enough, you will be able to be collected and go home 2-8 hours after your treatment. Even if the treatment has been successful, the doctor may tell you to continue taking some of your tablets for a while longer. An outpatient appointment will be arranged. Please remember it takes a while to recover from a general anaesthetic. For 24 hours after cardioversion: You must not drive You must not operate any potentially dangerous devices as your reflexes may be reduced You must not make any vital decisions or sign any legal documents Do not drink alcohol Do not boil a kettle or use anything that involves heat When rising to a sitting or standing position, do it slowly as you may become dizzy if you get up too quickly We advise you to rest for the remainder of the day after your treatment and to take the next day off work. Cardioversion 5

6 Information regarding risk Cardioversion is a safe procedure which has been performed in most hospitals in the UK for many years. Complications are rare, but there are risks that you need to think about before you sign the consent form. These risks are higher in patients who are very unwell or have certain medical conditions. You need to weigh up the risks of having the procedure or leaving the condition untreated against the potential benefit of the procedure. Below are approximate complication rates for patients undergoing cardioversion. However, you need to remember that these numbers include all patients, regardless of how ill they were to start with. For patients having cardioversion There is a risk of an anaesthetic problem or death for one patient in every 100,000 patients. There is a risk of having a stroke or another type of blood clot problem which is approximately one patient in every 1000 patients. There is a minor risk of slight burns to the chest from the paddles or adhesive pads used during the procedure. Rarely, some patients may require a temporary pacing wire to be inserted if the heart beats too slowly. Rarely the procedure causes a more serious, life threatening abnormal heart beat. This is so uncommon that there are no available statistics. 6 Cardioversion

7 References and further information [Last Accessed October 2012] [Last Accessed October 2012] NHS Constitution. Information on your rights and responsibilities. Available at constitution Cardioversion 7

8 If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice. North Bristol NHS Trust. This edition published May Review due May NBT002341

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