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Cardiolucent

Procedure

Cardioversion

Resetting an abnormal rhythm to normal sinus

Cardioversion is a procedure used to restore a normal (sinus) heart rhythm in patients with atrial fibrillation, atrial flutter, or certain other abnormal rhythms. It can be performed electrically — a brief, synchronized shock delivered under sedation through pads on the chest — or chemically with intravenous antiarrhythmic medication. Electrical cardioversion is highly effective, takes minutes, and is performed at Cedars-Sinai under the care of an electrophysiology team Dr. Kedan coordinates with directly.

What's Included

  • Pre-procedure echocardiogram or TEE to exclude atrial clot
  • Anticoagulation management before and after the procedure
  • Continuous EKG and vital-sign monitoring
  • IV sedation with anesthesia support
  • Synchronized electrical shock or IV antiarrhythmic infusion
  • Post-procedure rhythm assessment and recovery
  • Personalized rhythm-maintenance plan with Dr. Kedan

How It's Performed

Cardioversion is performed at Cedars-Sinai in a procedural area. After IV sedation is given, two adhesive pads are placed on the chest and a brief synchronized electrical shock is delivered. The procedure itself takes seconds and you are asleep for it. Chemical cardioversion is done by infusing an antiarrhythmic medication under continuous monitoring. Total time from arrival to discharge is typically 3 to 4 hours.

How to Prepare

  • Nothing to eat or drink for 6 to 8 hours before the procedure.
  • Take prescribed anticoagulation exactly as directed — this is essential for safety.
  • Arrange a driver — you cannot drive after sedation.
  • Bring an updated medication list and any prior EKGs.
  • Notify the team of any prior reactions to anesthesia or contrast.

What to Expect After

You will spend 30 to 60 minutes in recovery as sedation wears off. Mild chest-skin redness from the pads is common and resolves quickly. Anticoagulation typically continues for at least 4 weeks afterward. Dr. Kedan personally arranges close follow-up to confirm rhythm stability, optimize maintenance medication, and plan further therapy (such as ablation) if recurrence happens.

Indications

  • Persistent atrial fibrillation with symptoms despite rate control
  • Atrial flutter
  • First diagnosis of atrial fibrillation in a young or active patient
  • Hemodynamically tolerated ventricular tachycardia
  • Pre-ablation rhythm restoration when needed
  • Heart failure exacerbation triggered by sustained arrhythmia
  • Recurrence after prior successful cardioversion

Common Questions

Frequently Asked Questions

What is cardioversion?
It is a procedure that restores normal heart rhythm in patients with atrial fibrillation, atrial flutter, or related arrhythmias. The most common form is electrical cardioversion — a brief synchronized shock delivered under sedation. Chemical cardioversion uses IV antiarrhythmic medication for the same goal.
Where is it done?
Electrical cardioversion is performed at Cedars-Sinai under the care of an electrophysiology team. Dr. Kedan coordinates the procedure and remains involved in pre- and post-procedural care.
How long does it take?
The shock itself takes seconds. Including sedation, monitoring, and recovery, plan on 3 to 4 hours from arrival to discharge.
Is it painful?
No. You are sedated and asleep for the shock. Most patients have no memory of the procedure. Mild chest-skin redness from the adhesive pads is common afterward and resolves within a day or two.
How do I prepare?
Fast for 6 to 8 hours before the procedure, take your prescribed anticoagulation exactly as directed, arrange a driver, and bring an updated medication list.
Why is anticoagulation so important?
An abnormal rhythm can allow a small blood clot to form in the atrium. If a normal rhythm is restored before the clot is broken down, the clot can be ejected and cause a stroke. Adequate anticoagulation before and after cardioversion — typically at least 3 weeks before and 4 weeks after, or a confirmatory TEE — eliminates that risk.
What are the risks?
Cardioversion is very safe in experienced hands. Risks include stroke if anticoagulation is inadequate, transient arrhythmia immediately after the shock, skin irritation at the pad sites, and the small risks of brief anesthesia.
How successful is it?
Electrical cardioversion successfully restores normal rhythm in more than 90% of attempts. Long-term maintenance depends on the underlying arrhythmia, atrial size, medication strategy, and lifestyle factors — recurrence is common, and many patients eventually proceed to ablation.
Who interprets the result?
The electrophysiologist performing the case confirms rhythm restoration in real time. Dr. Kedan reviews the post-procedure EKG and personally manages your follow-up rhythm strategy.
How do I schedule one?
Cardioversion is typically planned after rhythm-control evaluation. Call Cardiolucent at (310) 304-5555 to begin the conversation.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.