Name of the Procedure:

Cardioversion, Elective, Electrical Conversion of Arrhythmia; Internal (Separate Procedure)

Summary

Cardioversion is a medical procedure that uses electrical impulses to restore a normal heart rhythm in patients experiencing arrhythmias. This document focuses on elective internal electrical cardioversion, performed to treat irregular heartbeats from within the heart.

Purpose

The procedure aims to correct abnormal heart rhythms, such as atrial fibrillation or atrial flutter, improving the heart's efficiency in pumping blood. The goal is to restore a normal rhythm, relieve symptoms, and reduce the risk of stroke or heart failure.

Indications

• Symptoms like palpitations, dizziness, chest pain, or shortness of breath due to arrhythmia
• Persistent or recurrent atrial fibrillation or atrial flutter
• Ineffectiveness of medications or other treatments
• Pre-approval by a cardiologist based on diagnostic criteria

Preparation

• Fasting for 6-8 hours before the procedure
• Medication adjustments as advised by a healthcare provider
• Blood tests, ECG, echocardiogram, and possibly imaging studies to assess heart condition
• Use of blood thinners if necessary to reduce blood clot risk

Procedure Description

1. Anesthesia: General anesthesia or deep sedation is administered to ensure the patient is asleep and pain-free.
2. Access: A catheter is inserted into a blood vessel and guided to the heart.
3. Electrical Impulses: Electrodes on the catheter deliver controlled electrical shocks directly to the heart tissue to reset the heart rhythm.
4. Monitoring: Continuous monitoring of the heart's response to the shocks.

Tools involved include:

• Electrocatheters
• ECG monitors
• Defibrillator

Duration

The procedure typically takes 1-2 hours, including preparation and recovery time.

Setting

The procedure is performed in a hospital, specifically in an electrophysiology lab or cardiac catheterization lab.

Personnel

• Cardiologist specialized in electrophysiology
• Anesthesiologist
• Cardiac nurses
• Technicians

Risks and Complications

Common risks:

• Bruising or bleeding at the catheter insertion site
• Minor skin burns from electrode patches Rare but serious risks:
• Stroke
• Heart attack
• Severe infection Management of complications involves prompt medical treatment and supportive care.

Benefits

• Restoration of a normal heart rhythm
• Relief from symptoms like fatigue and palpitations
• Reduced risk of stroke and other complications associated with arrhythmias Benefits are usually realized immediately or shortly after the procedure.

Recovery

• Monitoring in a recovery area for a few hours after the procedure
• Instructions to avoid strenuous activities for a week
• Follow-up appointments with the cardiologist for monitoring and medication adjustments

Alternatives

• Medication: Antiarrhythmic drugs
• Non-electrical cardioversion (chemical cardioversion)
• Catheter ablation
• Pros and cons: Medications may have side effects and limited effectiveness. Ablation is more invasive but may offer a more permanent solution.

Patient Experience

During the procedure, the patient is under anesthesia and will not feel the electrical shocks. Post-procedure, some patients may experience mild soreness or bruising at the catheter site. Pain management strategies, including medications, are provided to ensure comfort.