Cardioversion Daycase Admission

This is an electrical procedure used to convert an irregular or abnormal heart rhythm to a regular heart rhythm. This procedure is necessary if the control of your heart rhythm by tablets has not been effective.

An appointment will be arranged for you to attend Theatre Admissions Unit on a Friday at Doncaster Royal Infirmary. Access is via Gate 5.

Pre admission preparation:

IMPORTANT: You must continue to take your medications including your anti-coagulant (blood thinning) tablets e.g. Warfarin, Rivaroxaban, Dabigatran or Apixaban, Edoxoban, Acenocoumarol, Phenindione.

Blood thinning medications are used to prevent a stroke and it is very important these medications continue as prescribed pre and post Cardioversion.

No missed doses please or your procedure could be cancelled on the day.

If you take Digoxin please stop 2 days prior to procedure.

• During the week of the appointment you will be required to have a blood test. The blood test department is located in the Out-patients department via Gate 3.
• You will also have an Electrocardiogram (ECG) in the ECG Department located in South Block.
• The forms for these tests will be sent with your appointment.
• You should arrange transport home with a relative or a friend as you will not be allowed to drive home after the procedure.
• Bring with you a dressing gown, slippers and your medications.

Theatre admissions Unit

The day of the procedure

You must not eat or drink anything six hours before your admission. You can take few sips only of water to take morning medication.

On arrival to the Ward

You will be assessed by a Nurse. You will also be seen by the Anaesthetist and the Doctor in charge of your care.

The Doctor will explain the procedure and ask you to sign a consent form agreeing to the procedure and confirming that you have continued to take your anti-coagulant (blood thinning) tablets for at least four weeks and haven’t missed any doses.

You will be given a gown to wear for the procedure.

What does the procedure involve?

You will lie on a trolley and the nurse will attach you to a defibrillator by three monitor leads and two cold sticky pads (defibrillator pads) to your chest and back.

A blood pressure cuff will be applied to your upper arm. Both are required so that your heart and blood pressure can be monitored throughout the procedure.

A cannula (a Hollow plastic tube) will be inserted into a vein in the back of your hand or in your arm, this is to enable a short-acting sedation to be administered by an anaesthetist.

An Oxygen mask will be placed over your nose and mouth. Once asleep, a low-voltage electrical shock is administered by the Doctor to the chest wall in order to correct the heart rhythm.

A maximum of three shocks can be given. In most cases this procedure is effective, but the abnormal heart beat can recur and your doctor will monitor this.

After the cardioversion, you will be advised on which medications need to be continued. Alternative medication may be suggested if the procedure has not been successful.

You will feel tired and drowsy following the anaesthetic and should expect to rest in hospital for two to three hours.

Your recovery

A nurse will monitor your blood pressure, pulse and oxygen levels every half hour for two hours. You will receive oxygen until back on the Unit or are fully awake.

You may experience a slight ‘sunburn’ sensation on the chest wall. If this does occur, an after sun lotion may be applied to alleviate your symptoms.

When fully recovered, you will be allowed to eat and drink normally and lunch will be provided.

You will receive a further ECG which will be reviewed by the Doctor who will explain your results and discuss your medications.

The procedure is performed under short acting sedation therefore for the first 24 hours you are advised NOT to:

• Drive any vehicle, operate machinery, or undertake work involving danger to yourself or others.
• Use gas or electric appliances.
• Travel home alone.
• Use public transport.
• Be alone in the house.
• Make important decisions or sign important documents.
• Consume alcohol, sleeping drugs or tranquilisers, unless specifically prescribed.

You must have someone responsible to take you home and a responsible adult to stay with you for 24 hours after your procedure.

Discharge

Providing there have been no complications, you will be allowed home.

An appointment will be made for you to have an ECG in three months followed by a Cardiology follow up.

You will be given a copy of your discharge letter to keep and one will be sent to your GP electronically.

You may telephone the Theatre Admissions Unit for advice, the direct number is Tel: 01302 642332.

The Theatre Admissions Unit opening times are:
Monday – Friday 7.00am to 5.00pm.

If you need advice and the unit is closed please contact your GP Surgery.

Patient Advice & Liaison Service (PALS)

The team are available to help with any concerns, complaints or questions you may have about your experience at the Trust. Their office is in the Main Foyer (Gate 4) of Doncaster Royal Infirmary. Contact can be made either in person, by telephone or email.

The contact details are:
Telephone: 01302 642764 or 0800 028 8059
Email: dbth.pals.dbh@nhs.net