"A lot of people have so-called chronic AFib, where it's there all the time. But as long as their heart rate isn't too fast, they're able to live their lives normally, and in some cases don't even notice it," says William Whang, MD, assistant professor of clinical medicine in cardiology at Columbia University Medical Center.
But when you do have symptoms, that's a different story. If your heart goes in and out of a normal beat, you may be able to control it with medication alone. If you're in AFib all of the time, your doctor may recommend something else.
Reboot my heart
"This isn't a permanent fix," Whang says. Your heart could fall out of sync again by the time you get home. "But getting the person back into normal rhythm, even for a short time, can tell us whether or not that makes them feel better. That tells us what we should do about treatment."
Before you have a cardioversion, you'll probably need to take medication called a blood thinner for a month. This will give your body time to dissolve any blood clots lurking inside your heart that could come loose because of the procedure and lead to a stroke.
If your symptoms are too severe to wait that long, the doctor will check for clots in your heart by doing a transesophageal echocardiogram (TEE). While you're sedated, they'll put a long, flexible tube with a small device down your throat until it's behind the top of your heart. This device sends out sound waves and picks up their echoes to make a picture on a computer screen. If the doctor doesn't see any clots, you'll be good to go.
If you still can't seem to get control of your AFib, doctors may recommend a procedure to wipe out the heart tissue that's causing the misfiring signals. It isn't surgery, but you will need a small cut.
The doctor will thread a long, thin tube called a catheter through a vein from your leg or your neck into your heart. Then they'll use heat, cold, or radio energy to create scars on specific places of your heart, which stops them from sending or passing electrical signals.
Catheter ablation has its own risks, too. Overall, about 5% of patients have some type of complication, including bleeding where the catheter goes into your body or when it enters the heart, as well as a 1% risk of stroke. And in very rare cases -- fewer than 1 in 1,000 -- an opening can develop between the heart and the esophagus. "That's a life-threatening complication and is fatal about half of the time," Wylie says.
Three days after the 5k, I was still tired. I attributed it to the pace I kept up in the race. I tried checking my heart rate and discovered I had no rhythm. I even had my wife listen to my heart and she agreed the beats were sporadic and the strength of the heartbeats varied, too. As soon as the Intermountain Medical Center Heart Institute clinic opened on Monday morning, I was on the phone with a nurse who confirmed my fear and I was scheduled the following day to have my heart shocked back into rhythm.
After checking in at the front desk, I was taken to an exam room and put on a hospital gown. I had monitors placed on my chest to follow my heart rate and they took my blood pressure as well. My BP was 115 over 93 and my heart rate was ranging from 110 to 140+ beats per minute, compared to a normal heart rate of 60 to 100.
During the next hour, I looked to see what had been shared on Twitter while I was sedated so I could get a better idea of what happened. After going into light sedation, the scope was inserted into my esophagus and images were taken of my heart, which showed it was healthy (other than the abnormal rhythm) and I had no blood clots.
Cardioversion is a medical procedure that uses quick, low-energy shocks to restore a regular heart rhythm. It's a treatment for certain types of irregular heartbeats (arrhythmias), including atrial fibrillation (A-fib). Sometimes cardioversion is done using medications.
Cardioversion is different from defibrillation, an emergency procedure that's done when the heart stops or quivers uselessly. Defibrillation delivers more powerful shocks to the heart to correct its rhythm.
Your health care provider may recommend cardioversion if you have certain heart rhythm disorders, such as atrial fibrillation or atrial flutter. These conditions occur when the electrical signals that usually make the heart beat at a regular rate don't travel properly through the upper chambers of the heart.
Dislodged blood clots. Some people who have irregular heartbeats, such as A-fib, have blood clots form in the heart. Shocking the heart can cause these blood clots to move to other parts of the body. This can cause life-threatening complications, such as a stroke or a blood clot traveling to your lungs.
Before cardioversion, you may have an imaging test called a transesophageal echocardiogram to check for blood clots in the heart. Cardioversion can make blood clots move, causing life-threatening complications. Your provider will decide whether you need this test before cardioversion.
If you're having electrical cardioversion, a care provider places several large patches (called sensors, or electrodes) on your chest and sometimes your back. Wires connect the sensors to a cardioversion machine. The machine records your heart rhythm. It delivers quick, low-energy shocks to the heart to restore a regular heart rhythm.
Blood-thinning medications are usually taken for several weeks after cardioversion to prevent clots from forming. You'll need blood thinners even if no clots were found in your heart before the procedure.
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