Cardioversion: General advice for after your procedure

Post cardioversion procedure recommendations

In order to carry out the cardioversion procedure, you will have received a short-acting general anaesthetic or sedating medication. This can make you feel lightheaded or tired and can make it harder to coordinate your movements or think clearly. For your safety, do not undertake any activities in the list below for the first 24 hours after your procedure. You should also rest and ask someone to stay with you for these 24 hours even if you feel well.

• Do not drive, ride a motorcycle or ride a bicycle (your insurance will not cover you)
• Do not swim
• Do not drink alcohol
• Do not lock your bathroom/toilet doors
• Do not return to work (in some circumstances, you may require more than 24 hours between your cardioversion procedure and returning to work)
• Do not operate any potentially dangerous devices (e.g. kettles, cookers or irons) and do not operate heavy machinery
• Do not make any important or life changing decisions, write cheques or sign any legally binding documents in case these are contested

Skin care/discomfort

After your cardioversion, you may find that your skin in sore and red where the cardioversion pads were placed (this may look like sunburn). We may provide you with Flamazine cream to apply to the affected area if necessary, but a non-perfumed moisturising cream or after-sun cream can be used to soothe this. If you notice discomfort on your chest where the cardioversion pads were placed, you can take pain relief such as paracetamol for this.

Exercise

Refrain from vigorous physical exercise directly after your cardioversion. Speak to your doctor with any queries of what exercises can be carried out. You will be given advice on when you can start exercising again; this differs from person to person. Gradually increase your physical activity following your cardioversion procedure, aiming to build up to 2.5 hours of activity per week.

Eating and drinking

You may eat and drink when you feel ready to after your procedure. If you had a transoesophageal echocardiogram (TOE) with local anaesthetic throat spray prior to your cardioversion, do not have hot food or drink until at least 4 hours after your procedure.

Checking your pulse

Before going home, please ask your nurse to show you how to check your pulse if you are unsure. If you notice that your pulse has become irregular or your symptoms return, please inform your nurse led cardioversion team and make an appointment with your GP for an ECG to be carried out.

Checking your heart rate and blood pressure

Please monitor your heart rate and blood pressure at least once a week for 4 weeks after your cardioversion procedure. You will be asked to provide this information to your doctor/cardiac specialist nurse at your first follow-up appointment. They will use these to make any adjustments required to your medication.

Medication

You must continue to take your anticoagulant (blood thinning medication such as warfarin, apixaban, rivaroxaban, dabigatran or edoxaban) until instructed otherwise by your doctor or cardiac specialist nurse; this will be for a minimum of 4 weeks after cardioversion but may be lifelong treatment. This is to reduce the risk of forming blood clots that could cause a stroke.

Warfarin: Make sure you have regular appointments to check your INR levels. It is very important to maintain an INR target of 2.5 (range of 2-3) unless instructed otherwise.

Other medications: Please continue to take your regular medication unless instructed to stop. For example, digoxin will be stopped if your cardioversion is successful and other medication may be adjusted in your follow-up appointments if needed.

Lifestyle changes

These are recommended to improve your heart health and prevent future complications.

• Avoid or limit alcohol intake to less than 2 units per week (note alcohol may interfere with your anticoagulant medication – please speak to your doctor about this)
• Avoid or limit caffeine intake
• Increase your physical activity according to tolerance
• Maintain a healthy weight
• Eat a healthy, balanced diet and reduce salt intake
• Quit smoking

Follow-up appointments

• A doctor or nurse led telephone appointment will be arranged approximately 3-4 weeks after your cardioversion procedure.
• Your GP will receive notification of the outcome of your cardioversion procedure.
• A consultant appointment will be scheduled to discuss future plans/treatment and details of this will be posted to you.

If you have any concerns or you need further advice, please contact the nurse led cardioversion team on 01223 216042 or email the Cardioversion nurse. You can also seek medical advice from your GP or NHS 111.