Understanding Cardioversion and Why It's Done
Last time, I talked about cardioversions, and their purpose. In today's blog, I'll talk about my own cardioversion.
Once I was given the diagnosis of Atrial Fibrillation as the reason for my breathlessness and strange feelings in my chest, I decided to go to a cardiologist who specialized in irregular rhythms called an Electrophysiologist.
His concerns were to manage and control the atrial fibrillation itself with medication to slow down the heartbeat, and to prevent a stroke, the number one, potentially deadly complication of afib, by thinning my blood to the INR ratio number between 2-3. I took Coumadin and was required to go into a special lab to have a blood prick done weekly. Fortunately for me, my body responded well to the Coumadin and I settled in at about a 2.2 INR.
But afib made me feel tired and unwell. Although the beta blockers and the digoxin were keeping the heartbeat in the 70s range, it was, of course, irregular. Digoxin and possibly coumadin as well seemed to affect my appetite. I didn't have one! I ate a lot less, which didn't bother me because I lost those 15 pounds I really wanted to lose and looked terrific. Unfortunately, the meds also seemed to thin my hair, but I thought it was a fair trade.
Finally, after I was in INR for over nearly three months, my doctor agreed to do a Cardioversion.
Most times when a Cardioversion is done for atrial fibrillation, the patient has been taking antiarrythmic drugs. I had done a lot of reading about antiarrythmics, and I did not want to start taking them. Many doctors will not do a cardioversion unless the patient is also taking these drugs, but I was adamant, and my doctor agreed to give me a shot at it.
On the day of my procedure, I arrived at the hospital to check into the day unit at about 9 AM. Of course I had nothing to eat or drink from midnight before. I changed into a gown, was set up for an intravenous line, and had several electrodes (similar to an EKG) attached to my chest.
I was pretty nervous. After all, I was going to have my heart rhythm briefly stopped and shocked into another rhythm. Irregular as my beat was, it was still a beat! I had done a lot of reading about this test, which I always recommend, and I had a lot of faith both in the test and in my doctor and hospital.
What would it feel like? Would it work? These were the questions that ran through my head until my doctor arrived between other heart procedures he was doing. At that point, the anesthesia nurse and another nurse administered a short acting but potent drug (they nicknamed it "milk of amnesia") which initially made me very relaxed and of course, that is the last I remembered of the procedure.
When I became conscious again, I was half sitting up on my bed, my doctor had dashed off, and asked if the procedure were over. I learned that during my procedure my doctor had administered an electric shock (called a "joule") of electric current, and that my heart had responded on the first joule by converting into a normal sinus rhythm.
I felt a lightness in my chest that I had not had for months, and watched the monitor with a big smile as my heart beat normally. I had a glass of cranberry juice and a muffin, my doctor had left two (and only two, he promised) antiarrythmic meds called Rhythmol for me to take before I left the hospital, and soon I was on my way home, where I rested and watched some TV for the rest of the day.
I am one of the lucky ones, approximately 20-25% of afib patients, whose conversion has lasted. For this I am very grateful.
And my cardioversion remains one of the easiest, least traumatic, painless medical procedures I have had.
(Next time, I'll talk more about atrial fibrillation, irregular heartbeats, how to deal with them, and how to prevent their return.)