Electrical Cardioversion
Electrical cardioversion is used to terminate atrial fibrillation but in and of itself has no long-term effect on the recurrence of AF. Patients are generally admitted as an outpatient to the hospital, placed on a heart monitor, an intravenous form of anesthetic is given and patches are placed on the chest.
Once the patient is completely anesthetized, a small electrical charge over the heart is delivered. This electrical charge causes a momentary electrical discharge of all the cardiac cells and allows the primary pacemaker, the SA node, to take control of the rhythm, thus stopping the atrial fibrillation and resetting the heart.
Sometimes, cardioversion is done in conjunction with antiarrhythmic medications to reduce the likelihood of recurrence of the AF.
Paroxysmal AF occurs intermittently and varies in frequency and duration from a few seconds to more protracted episodes lasting several hours or even days.
Persistent AF on the other hand, becomes the primary heart rhythm and it is usually unresponsive to medical therapy or other non-pharmacologic interventions such as electrical cardioversion. This form of AF is typically seen in an older population.
Well last night my "A-Fib" stopped on it's own after 5 days. :( I am happy it stopped but now I am worried when it will come back and if it will last that long again. I am still going to go see my cardiologist (again) for advice. Thanks for all the warm thoughts. Just thought I would update everyone and let them know my heart is back to normal rhythm for now. :-[
- Epoman
Hello Epoman!
I would have posted to you yesterday, but had to wait for that darn moderator to manually activate me. :D ;)
I know that you will tell me to go post an intro, but I am a lurker and plan on staying that way for a while yet. I'm pre-dialysis so I'm not ready to be here fully, but wanted to offer you some encouragement. Your forum is preparing me for my future. This is my small way of saying thank you to you and your members. If I can help you then I help them because it is obvious that they care so much for you.
I'm a register Cardiac Ultrasound tech (echo) and see many people, young and old, in and out of A-fib that live with this condition just fine. The reason that you probably have a problem with this is because of your enlarged heart caused by your other medical problems. Do you happen to know the size of your atrium's? This is key in knowing if you will stay in normal sinus rhythm with medication and/or cardioversion.
The potential for clots to form are there, but if your heart function(ejection fraction) is still really good then your risk is a lot less. We typically see elderly people with barely any function with clots, not in the chamber of the heart itself, but in the left atrial appendage. The appendage is a small pouch in the left atrium that serves no purpose. I see a lot of young dialysis patients BUT it isn't a common thing to see clots in their heart. I know that you are terrified and it feels that your world is falling apart once again. You seem like a very strong person and I know that you will do very well with this after you absorb it all.
They normally start you out on medication and if that doesn't work then they would need to cardiovert you.
This is exactly what our hospital does.
Most of our patients come in 1 1/2 hours prior to having a Transesphogeal Echo and Cardioversion and leave a couple hours after the procedure. We start an IV and make sure that you haven't had anything to eat or drink in the past 6 hours. You will sign a consent. They will sit you up and listen to your lungs and put a large patch on your chest and back. They will then hook you up to the EKG monitor, Blood pressure cuff, Pulse Oximetry and Oxygen. They will normally have 1 nurse, Doctor and Echo tech in the room.
They start by spraying your throat three times with cetacaine or other numbing agent. My patients always tell me that that is the worst part of the entire test. Rotten bananas is what it smells like, cheap whiskey is what it tastes like. They then will give you something to make you sleepy or nothing at all if you want to be awake for it. We do have a few patients that will go thru the TEE without sedation. Me, I'd want the drugs if they are giving them! :)
After you are sleepy they will give you a bite block to bite on and then put the TEE scope to the back of your throat and ask you to swallow. The scope is about as big around as your little pinky finger and most patients have no problem swallowing it. When they get the scope down they will look at your heart from the esophagus and briefly from the stomach. You might feel a bit of pressure when they move the scope around, but many people don't and are surprised when we tell them we are finished.
We do TEE's vs Echo's because the appendage can NOT be seen on a surface(chest) Echocardiogram.
After they pull out the scope they will give you more sedation for the cardioversion. Many many many people go thru a cardioversion without remembering a thing when given more of the same drugs they gave for the TEE. I do think there are people out there that are not given enough sedation and do remember, so that being said...I'd personally demand that someone from anesthesia be there to sedate me. If they don't honor that wish then when they try to wake you up and you hear them, open your eyes or move.
They will then shock you back into normal rhythm, get an EKG to confirm it and then take you back to your room.
I hope that I didn't scare you more and some of the stuff helped you understand a bit more. It is important to know what your heart size measures and how well it is squeezing. Ask them to send you a copy of your Echo report and PM me if you want my opinion on what is viewed as normal, enlarged or severally enlarged.
Take care and know that there are many here that care about your well being....even the lurkers. :)
Hello Epoman!Ya *Kana* IS a class act! Out of all the first posts this was the most caring! :cuddle;
I would have posted to you yesterday, but had to wait for that darn moderator to manually activate me. :D ;)
Well last night my "A-Fib" stopped on it's own after 5 days. :( I am happy it stopped but now I am worried when it will come back and if it will last that long again. I am still going to go see my cardiologist (again) for advice. Thanks for all the warm thoughts. Just thought I would update everyone and let them know my heart is back to normal rhythm for now. :-[
- Epoman
Just quoting myself, this whole a-fib situation has really got me depressed and worried more than I have ever been in my whole life. I can and have handled all the other bullshit, but now we are talking about my heart. That's the last straw, I feel like I don't have much time left with my son and it makes me so sad, but not sad for me, but sad knowing that my son will cry so much and feel such a loss, since him and I are so close. Why should such a small person have to feel such pain at such a young age? Why GOD?
Please GOD if you are watching while I type this (I know you are), please let my son become a man before you take his father, I know he won't be the first or the last to lose a father at such a young age. But please Lord I will do anything, I don't care about myself. I just beg you GOD, let me finish the job you let me start in the first place. Let me raise my son, then after he is an adult you can have me. Nick is yours GOD and I am just borrowing him on this earth, you made me his father to guide him and to show him your greatness. So let me live long enough to guide him to you. Keep this beaten heart pumping for a little while longer, if not for my sake, for a little innocent young mans sake. If something were to happen to me, it would alter his life for ever. If I have done things in this lifetime to warrant such a sickened body, then punish me until you see fit, but please do not punish YOUR "other" son Nick.
Well last night my "A-Fib" stopped on it's own after 5 days. :( I am happy it stopped but now I am worried when it will come back and if it will last that long again. I am still going to go see my cardiologist (again) for advice. Thanks for all the warm thoughts. Just thought I would update everyone and let them know my heart is back to normal rhythm for now. :-[
- Epoman
Just quoting myself, this whole a-fib situation has really got me depressed and worried more than I have ever been in my whole life. I can and have handled all the other bullshit, but now we are talking about my heart. That's the last straw, I feel like I don't have much time left with my son and it makes me so sad, but not sad for me, but sad knowing that my son will cry so much and feel such a loss, since him and I are so close. Why should such a small person have to feel such pain at such a young age? Why GOD?
Please GOD if you are watching while I type this (I know you are), please let my son become a man before you take his father, I know he won't be the first or the last to lose a father at such a young age. But please Lord I will do anything, I don't care about myself. I just beg you GOD, let me finish the job you let me start in the first place. Let me raise my son, then after he is an adult you can have me. Nick is yours GOD and I am just borrowing him on this earth, you made me his father to guide him and to show him your greatness. So let me live long enough to guide him to you. Keep this beaten heart pumping for a little while longer, if not for my sake, for a little innocent young mans sake. If something were to happen to me, it would alter his life for ever. If I have done things in this lifetime to warrant such a sickened body, then punish me until you see fit, but please do not punish YOUR "other" son Nick.
Well Epoman I think your prayer worked.
:waving;
Glad it was mostly good news! :2thumbsup;
Tylenol 4 :o Wow! That has to be some damn mean pain! Hope that hip gets better fast.
You do so much for us, you are always in my prayers. :cuddle;
Well just an update,
It has been about 18 days since I was last in A-Fib and my BP and pulse has been good, my rate was getting a little low like in the 40's but I didn't have symptoms with it. I stopped taking my Atenolol (it helps keep my pulse low) because the cardiologist said to stop it unless my pulse goes above 70 since with Atenolol is was getting to low.
My pulse has not been low, it has be steady in high 50's and low 60's and I have been feeling pretty good. And I have had no problems. I have been taking a little less thyroid med so I think it is somehow related to my thyroid, even if my neph disagrees.
I have just the thing to cheer you up but unfortunately I can't show it to you here. Oh well what the hell here ya go.
(http://i9.photobucket.com/albums/a80/CFseXybaBi780/stripper.gif)
Oh my!