Download A guide to your cardioversion - Salford Royal NHS Foundation Trust

University Teaching Trust
A guide to your
cardioversion
Turnberg Building
Department of Cardiology
0161 206 8310
© G16102610W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2016.
Document for issue as handout. Unique Identifier: MED 65 (16). Review date: December 2018.
Please contact our
advanced nurse
practitioner prior to
your procedure on:
0161 206 8310
Monday to Thursday
9am to 5pm. If you
have any questions
PLEASE READ THIS
BOOKLET CAREFULLY
What is cardioversion?
Cardioversion is a procedure
for treating abnormal
heart rhythms such as atrial
fibrillation and atrial flutter.
The aim is to convert the
heart to a normal rhythm
by delivering a controlled
electric shock to the heart. The
procedure is carried out under
general anaesthetic as a day
case procedure.
1
Why am I having this
procedure?
Are there any risks
involved?
Some people are unaware of
their abnormal heart rhythm,
whilst others experience
symptoms such as extreme
fatigue, shortness of breath,
palpitations and a lack of
exercise tolerance. There is
also a small chance of having a
stroke.
Complications from a
cardioversion are rare.
When the heart beats
irregularly the upper parts of
the heart do not contract and
pump out the blood properly.
This can result in not enough
blood leaving the heart, which
causes the above symptoms.
It can also cause small blood
clots to occur in the chambers,
which could lead to a stroke.
Taking anticoagulation reduces
this risk.
A common complication is
temporary skin redness over
the chest area at the site of
the electric shock. This can be
relieved by applying a cream if
necessary. The risk of having a
stroke is under 1% (1 in 100).
How successful is the
procedure?
Immediate success (the return of
a normal, regular heart rhythm)
is achieved in more then 90% of
patients having cardioversion.
However, the abnormal heart
rhythm might return. In a few
people this happens within hours
or days of the cardioversion;
in others it happens weeks or
months later. After 12 months
50-70% of patients will still
have a normal heart rhythm.
Are there any alternatives?
Atrial fibrillation ablation
An alternative treatment for
atrial fibrillation is to ablate the
arrhythmia using a steerable
catheter placed into the heart
through a vein. The tip of the
catheter is either heated or
cooled to produce controlled
burns to the inner surface of
the heart in order to prevent
atrial fibrillation occurring.
This is a rapidly developing
technique which is
recommended when standard
treatment such as medication
and cardioversion have not
been successful.
It is not recommended as a
first-line treatment for atrial
fibrillation at present.
Your doctor will only
recommend this treatment if
he/she feels that the benefits
outweigh these small risks.
© G16102610W. Design Services, Salford Royal NHS Foundation Trust,
All Rights Reserved 2016. Document for issue as handout.
Unique Identifier: MED 65 (16). Review date: December 2018.
2
Preparation for the
procedure
You will be prescribed a drug
to thin the blood in the weeks
prior to the cardioversion
to reduce the risk of blood
clots. Your blood needs to
be adequately thinned for
at least 3 weeks prior to
cardioversion. You may attend
the anticoagulation clinic
regularly. Once your blood is
thin enough we will list you for
cardioversion.
If you are on digoxin you will
be asked to stop this 2 days
before cardioversion.
You will have a final set of
blood tests and a heart tracing
(ECG) in the days prior to your
cardioversion.
This is a day case procedure.
You will need someone
at home to look after you
overnight.
Admission to hospital
You will be asked to attend the
Day Surgery Unit (Red Area) at
12 o’clock on the day of your
cardioversion.
Do not have anything to eat
after 7.30am, and then water
only up until 11.30am.
Patients with diabetes
Those patients with diabetes
that are on the afternoon list
should have breakfast and
take their tablets for diabetes
as normal. Those patients on
Insulin should take only 1/2 their
normal dose with breakfast.
DO NOT HAVE LUNCH AND DO
NOT TAKE ANY DIABETIC TABLETS
OR INSULIN AT LUNCH TIME.
Please bring your anticoagulation
booklet and any medications that
you are prescribed with you.
Please also bring a dressing gown
and slippers (we will give you a
theatre gown for the procedure).
You will be seen by a member of
the cardiology team to ensure that
you understand the procedure.
3
The Cardioversion
procedure?
You will be taken to theatre
on your bed. We will monitor
your heart and give you oxygen
to breath. We will also place
pads on your chest and back
(defibrillation pads). The
anaesthetist will then place
a fine tube into the back of
your hand and administer the
anaesthetic. Once you are
asleep we will give a controlled
shock to your heart. You will
not feel anything.
After the procedure?
You will wake up 5-10 minutes
after the procedure, initially
in a recovery area. Once you
are fully awake you will be
transferred back to the Day
Surgery Unit where you will be
monitored for two hours. You
will be offered something to
eat and drink.
You will be ready to go home
3-4 hours after the procedure.
The anaesthetic can make you
feel tired, clumsy or forgetful for
about 24 hours. You should not
drive, operate machinery or make
important decisions for 48 hours.
You will be given advice
regarding any changes to your
medication before you go
home. Even if the cardioversion
is successful, it is very important
that you continue your
anticoagulation until advised
Further information is available
from:
The British Heart Foundation
Greater London House,
180 Hampstead Road,
London, NW1 7AW
020 7554 0000
www.bhf.org.uk
Endorsements
Dr Alan Fitchet
Cardiology Consultant
Amanda Darkin
Cardiac Procedures Advanced Nurse
Practitioner
© G16102610W. Design Services, Salford Royal NHS Foundation Trust,
All Rights Reserved 2016. Document for issue as handout.
Unique Identifier: MED 65 (16). Review date: December 2018.
4
© G16102610W. Design Services
Salford Royal NHS Foundation Trust
All Rights Reserved 2016
This document MUST NOT be photocopied
University Teaching Trust
Information Leaflet Control Policy:
Unique Identifier: MED 65 (16)
Review Date: December 2018
For further information on this leaflet, it’s references and sources
used, please contact 0161 206 8310.
If you need this interpreting please telephone
Copies of this information are
available in other languages
and formats upon request.
In accordance with the
Equality Act we will make
‘reasonable adjustments’
to enable individuals with
disabilities, to access this
treatment / service.
Email: [email protected]
Salford Royal operates a smoke-free policy.
For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service
on 0161 206 1779
Salford Royal NHS Foundation Trust
Stott Lane, Salford,
Manchester,
M6 8HD
If you would
like to become a
Foundation Trust
Member please visit:
If you have any suggestions
as to how this document
could be improved in the
future then please visit:
Telephone 0161 789 7373
www.srft.nhs.uk/
for-members
http://www.srft.nhs.uk/
for-patients
www.srft.nhs.uk