Electrical cardioversion is frequently used for atrial fibrillation to restore a normal sinus rhythm if the heart rhythm does not convert on its own. You may also elect to have cardioversion if you find your symptoms bothersome.

If your atrial fibrillation has recently started and it has been continuously present for less than 48 hours, your doctor may consider using electrical cardioversion or antiarrhythmic medications to convert your heart to a normal rhythm. If your atrial fibrillation has lasted for more than 48 hours, it is possible that the blood that is pooling in the quivering upper heart chambers (atria) has led to the formation of blood clots. Cardioversion could cause a blood clot to be pumped into the bloodstream, travel to the brain, and cause a stroke.

If you've had atrial fibrillation for more than 48 hours, your doctor will probably prescribe anticoagulants for several weeks to reduce the risk of stroke before attempting cardioversion.

However, if you have severe symptoms, such as very low blood pressure, you may have cardioversion immediately. In this case, your doctor may use a transesophageal echocardiogram to assess whether you have any clots in your heart that could cause a stroke. If the transesophageal echocardiogram shows that your heart is clear of clots, you may have cardioversion. Anticoagulant medication is taken for at least 3 weeks after cardioversion.

If medicines do not keep you in normal rhythm and you continue to be bothered by your symptoms, catheter ablation might help you. Catheter ablation is used to try to cure atrial fibrillation or to control the heart rate. The procedure destroys small areas in the heart that might be causing atrial fibrillation or keep it going. You may need a permanent pacemaker along with catheter ablation.

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