Electrical cardioversion involves giving the patient a general anaesthetic, and applying electrical shock on specialised pads on the person’s chest. The sudden electrical jolt can restore the irregular heart beat (usually atrial fibrillation or flutter) to normal sinus rhythm. Up to three shocks in increasing energy may be given to restore a regular heart rate. The patient is typically pre-treated with a blood thinner (warfarin) for at least 4 weeks beforehand to prevent clots from building up in the upper heart chamber (left atrium). An alternative is to perform a trans-oesophageal echocardiogram (TOE – advancing a video tube down the oesophagus to the stomach and view the heart chambers from inside with better clarity) to exclude any clots from being present before performing the electrical cardioversion (TOE-guided cardioversion).
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