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WELCOME TO THE GLENFIELD CARDIOLOGY UNIT
You have been asked to attend the ward to have an elective
External Cardioversion. This booklet has been designed to help
you understand about your forthcoming procedure. Hopefully it
will answer any queries and alleviate any fears you may be
experiencing.
If you have any questions, do not hesitate to ask your Named
Nurse who will be looking after you.
WHAT IS CARDIOVERSION?
To understand what a cardioversion is, you must first understand
the normal heart rhythm and also understand the abnormal rhythm
that you may be experiencing.
www.yourheart.org.uk is one of the first interactive web sites for
heart patients and their relatives and friends in the UK. This site
will offer heart and health related information available.
TRANSLATION
If you would like this information in another language or format,
please contact the Service Equality Manager on 0116 258 4382.
NORMAL HEART RHYTHM
Normally the signal that tells the heart to beat comes from a group
of pacemaker cells in the heart called the sino atrial node (SA
node). This starts electrical activity that produces contraction of
the two atria (upper heart chambers) and two ventricles (lower
heart chambers). The contraction of the heart produces the
heartbeat and blood is forced out into the arteries of the body. In
most people the heart rate at rest is between 60-80 beats per
minute.
When we exercise or are under stress, the pacemaker speeds up
its rate of discharge of electrical activity as it responds to nervous
and chemical influences in the body. Individuals can often feel
this increase and are aware of this fast heart rate. When the
exercise ceases or when the individual is less stressed, the heart
slows to its usual rate.
Haddaad rabto warqadan oo turjuman oo ku duuban cajalad
ama qoraal ah fadlan la xiriir, Maamulaha Adeegga Sinaanta 0116
2584382.
Eĝer bu broşürün (kitapçıĝın) yazılı veya kasetli açıklamasını
isterseniz lütfen servis müdürüne 0116 258 4382 telefonundan
ulaşabilirsiniz.
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HAS MY CARDIOVERSION BEEN SUCCESSFUL?
Your consultant/senior doctor who
performed the cardioversion will see
you on the ward and explain in full
the result of your cardioversion also
at this time they will discuss further
treatment/change in medication if
necessary.
RISKS
 You may experience soreness on your chest from where the
paddles were placed to deliver the electric shock. If you
experience any pain/discomfort, do not hesitate to let your
nurse know he/she will be able to apply some cream to ease
the soreness.
 Remaining in AF or reverting back to AF after a short time.
 There is an increased risk (5% - 1 in 20) of having a stroke if
your not adequately anti-coagulated.
GOING HOME
Before going home your nurse will remove the needle in your
hand and will give you a discharge letter to give to your GP. You
will also be given a letter with an appointment to return to clinic for
an ECG one week and four weeks following your cardioversion.
The nurse will also give you some cream to apply to your chest if
redness or soreness occurs where the paddles were placed.
It is essential that a family member or
friend collect you from the ward and
stay with you overnight.
YOU ARE NOT ALLOWED TO
DRIVE FOR 24 HOURS FOLLOWING YOUR CARDIOVERSION
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ABNORMAL HEART RHYTHM ie TACHYCARDIA
Occasionally, electrical signals arise in areas of the heart away
from the normal pacemaker (sino-atrial node). This may be in the
atria (atrial ectopic beats or atrial fibrillation), atrioventricular node
(AV nodal tachycardia) or ventricles (ventricular ectopic beats of
ventricular tachycardia). They produce a heartbeat, which comes
earlier than expected this is called an ectopic beat. This alone is
not dangerous and the effect on the heart is minimal.
Alternatively, a fast heartbeat that is persistent is called
tachycardia. This is usually caused by abnormal activation of the
heart in what is called a ‘re-entrant circuit’. If the heart rate is
increased to 150-200 beats per minute, the heart tends not to
work as effectively and the patient may feel unwell. The
experience of palpitations in this form can often be frightening to
the individual concerned.
These
tachycardia/irregular
heartbeats can be treated with
special drugs.
If the drugs
have been ineffective or are
thought to be unsuitable, one of
the methods of treating the
tachycardia is by a process called Cardioversion.
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CARDIOVERSION
PREPARATION FOR THE PROCEDURE
Cardioversion is when an electrical shock is delivered to the heart.
The electrical shock interrupts the ‘re-entrant circuit’ that causes
the tachycardia and resets the heart back to its normal sequence.
You should not have anything to eat or drink from midnight. You
can have an early morning drink no later than 6.00am. Information
regarding this will be given at your pre admission appointment.
PRE ADMISSION APPOINTMENT PRIOR TO PROCEDURE
WHAT DOES THE PROCEDURE INVOLVE?
You will be required to attend our Pre admission Clinic 3 days
prior to your cardioversion where the pre admission sister will take
a medical history/nursing assessment and relevant investigations
will be carried out including blood tests. Also at this time a full
explanation about your procedure and your stay in hospital will be
given.
MEDICATION
When you arrive on the ward you will meet
the nurse who will be caring for you and
he/she will assist you in preparing for the
test. The procedure will take place within
the ward area. The nurse will also put a
needle in the back of your hand to allow
any drugs to be given during the
procedure. You will be asked to put on a hospital gown.
If you are on tablets to control the rate of your
heart beat you should continue those unless
advised otherwise. Full explanation about your
medication and instructions regarding taking
medication will be given at the time of your pre
admission appointment.
You will have leads attached to your chest so that a tracing of your
heart can be displayed on the cardiac (heart) monitor and you will
be asked to lie in a flat position with one pillow if possible. You
may be required to remove any dentures. The anaesthetist/doctor
will give you medication through the needle in your hand to sedate
you and will ask you to breathe deeply into an oxygen mask.
WARFARIN
Before undergoing external cardioversion you must be taking
Warfarin for at least 6 weeks. It is vitally important that your blood
test (INR) runs above 2 for at least 6 weeks prior to your
cardioversion, and at the time of procedure between 2-3·5.
Please ensure you have a weekly INR blood test for 3 consecutive
weeks prior to you admission date. Your INR blood test will be
taken at your Pre-admission appointment, and you will be advised
before leaving the clinic on your dose of Warfarin to take.
Following this medication you will be asleep. The electrical shock
is delivered by placing two paddles in the appropriate position on
your chest. The paddles are attached to an electrical defibrillator.
You will be unaware of this occurring. When you wake up after
the cardioversion has been completed you may feel sleepy. An
oxygen mask may be in place. When you are fully awake, your
nurse will help you to sit upright and will remove the oxygen mask.
During this time your nurse will measure your pulse and blood
pressure at intervals. You will be allowed to eat and drink once
you are fully awake.
A routine ECG will be taken post
cardioversion. You will be on bed rest for approximately 2 hours
post cardioversion.
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CARDIO-RESPIRATORY DIRECTORATE
This booklet has been produced by:
The Cardio-Respiratory Patient Information Group
ELECTIVE EXTERNAL
CARDIOVERSION
Origination Date: January 2002
Updated: March 2004
A PATIENT GUIDE
University Hospitals of Leicester NHS Trust
Glenfield Hospital
Groby Road
Leicester
LE3 9QP
Telephone: 0300 303 1573
Fax: 0116 2583950
Minicom: 0116 2879852
University Hospitals of Leicester
NHS Trust
Glenfield Hospital