Cardioversion
Cardioversion restores a normal heart rhythm in people with certain arrhythmias such as atrial fibrillation. It is most often done electrically — a brief, controlled shock delivered under short sedation — or sometimes with medication, returning the heartbeat to a regular pattern.
Medically reviewed by the Florence Healthcare medical team · Last reviewed June 2026
Overview
Cardioversion is used to bring an irregular or fast heart rhythm — most commonly atrial fibrillation or atrial flutter — back to a normal pattern. In electrical cardioversion, you are given short-acting sedation and a synchronized electrical shock is delivered through pads on the chest. In pharmacological cardioversion, medication is given instead, under monitoring. Because restoring rhythm can dislodge a clot, blood-thinning medication is taken for several weeks beforehand, and a transesophageal echo may be done first to make sure there is no clot in the heart.
International patients receive coordinated anticoagulation planning, the procedure and follow-up, with a clear estimate in advance.
Who is a candidate?
- Atrial fibrillation or atrial flutter causing symptoms
- Arrhythmia affecting how well the heart pumps
- A fast arrhythmia where restoring normal rhythm is the goal
- Suitable after an adequate period of anticoagulation
- As part of a rhythm-control treatment plan
What happens
- 1
Preparation
You take blood-thinning medication for several weeks beforehand; a transesophageal echo is often done to exclude a clot, and you fast before sedation.
- 2
During the procedure
For electrical cardioversion you are sedated briefly and a synchronized shock is delivered through chest pads; for pharmacological cardioversion, medication is given while your heart is monitored.
- 3
Afterwards
You recover from the sedation, your rhythm is checked, you continue your medication and usually go home the same day.
Benefits
- Quickly restores a normal heart rhythm
- Relieves symptoms such as palpitations and breathlessness
- Improves how efficiently the heart pumps
- A short procedure, and it can be repeated if needed
Risks & considerations
- The arrhythmia can return over time
- A small risk of stroke, minimized by blood-thinning medication beforehand
- Skin irritation from the pads
- The usual effects of short sedation
Conditions this treats
Where it is performed
This procedure is delivered by our Heart Center.
Learn more before you decide
Provider-reviewed guides on the related conditions, symptoms and tests in our Health Library.
Cardioversion — frequently asked questions
Both can work; electrical cardioversion is quick and effective and is done under brief sedation, while medication may be used in selected cases. Your cardiologist will recommend the best option.
No — for electrical cardioversion you are given short-acting sedation and are asleep for the shock.
Restoring normal rhythm can dislodge a clot and cause a stroke. Several weeks of anticoagulation, and often a pre-procedure echo, greatly reduce this risk.
It can. Cardioversion restores rhythm but does not always keep it; some people need repeat treatment, medication or catheter ablation.
You receive a transparent, itemized estimate, including the anticoagulation and any pre-procedure echo.
Related treatments
Considering cardioversion?
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