Cardioversion, elective, electrical conversion of arrhythmia; external
CPT4 code
Name of the Procedure:
Cardioversion, elective, electrical conversion of arrhythmia; external
Common names: Electrical Cardioversion, Elective Cardioversion
Summary
Electrical Cardioversion is a medical procedure that uses a controlled electric shock to restore a normal heart rhythm in patients with certain types of arrhythmias (irregular heartbeats). It is typically planned and performed in a hospital.
Purpose
Cardioversion treats arrhythmias, especially atrial fibrillation and atrial flutter, helping to reset the heart to its normal rhythm. The goal is to alleviate symptoms such as fatigue, shortness of breath, and palpitations, and to prevent complications like stroke.
Indications
- Persistent atrial fibrillation (AFib)
- Atrial flutter
- Ventricular tachycardia
- Symptomatic patients not responding to medication
Preparation
- Fasting for at least 6-8 hours before the procedure
- Adjustments or temporary cessation of certain medications (anticoagulants, anti-arrhythmics)
- Pre-procedure diagnostic tests, including an electrocardiogram (ECG) and blood tests
- Echocardiogram to rule out blood clots in the heart
Procedure Description
- Patient is sedated or given light anesthesia to ensure comfort.
- Adhesive electrode pads are placed on the chest.
- A defibrillator delivers a timed electric shock synchronized with the heartbeat.
- The shock briefly stops and then restarts the heart, ideally restoring a normal rhythm.
- Monitoring continues to ensure the heart maintains the new rhythm.
Duration
Typically 5-10 minutes, though preparation and recovery may take a few hours in total.
Setting
Hospital, often in a specialized cardiology unit or an outpatient clinic with appropriate monitoring facilities.
Personnel
- Cardiologist or electrophysiologist
- Anesthesiologist or sedation nurse
- Cardiac nurse
Risks and Complications
- Skin burns or irritation from the electrode pads
- Risk of stroke if blood clots are present in the heart
- Arrhythmias may not resolve or may recur
- Anesthesia-related risks including allergic reactions
Benefits
- Restores normal heart rhythm, improving symptoms and quality of life
- Reduced risk of complications like stroke and heart failure
- Immediate improvement in symptoms such as palpitations and breathlessness
Recovery
- Monitoring for several hours post-procedure
- Instructions on medications to prevent recurrence of arrhythmia
- Avoid driving or operating heavy machinery for 24 hours
- Follow-up appointments with ECGs to ensure sustained normal rhythm
Alternatives
- Pharmacologic cardioversion (medication-based)
- Catheter ablation (radiofrequency or cryoablation)
- Implantable devices (pacemaker, defibrillator)
- Cons: Medications may have side effects; ablation is more invasive; implantable devices require surgery
Patient Experience
Patients may feel groggy from sedation post-procedure. There may be minor discomfort where electrodes were placed. Pain management includes over-the-counter pain relievers if needed. Staying hydrated and rested is recommended, with a gradual return to normal activities.