Chemical cardioversion


The process of converting an abnormal cardiac rhythm to a normal one using medication is known as chemical cardioversion. The reason for your irregular rhythm, its duration, the drug your doctor choose, and other factors will all affect how well this treatment goes.

Another name for this kind of cardioversion is pharmacologic cardioversion.

Drugs for chemical cardioversion can:

  • Ease the workload of your heart.
  • Lead to the relaxation of your heart muscles.
  • Make your blood vessels.
  • Reduce the speed of the electrical impulses that instruct your heart to beat.

Your heartbeat is typically initiated by your sinoatrial node. After that, electrical impulses pass through the right atrium and atrioventricular node. They finally reach your ventricles, which are your bottom chambers. An irregular heart rhythm can occur when anything goes wrong with the coordinated process of sending a signal through the various components of your heart.

Your heart may not pump blood effectively to the rest of your body when its rhythm is abnormal. Your blood contains oxygen, which is necessary for all of your cells, especially for the cells in your brain. Chest pain, poor energy, breathing difficulties, dizziness, exhaustion, and general malaise can all be caused by inadequate blood flow.

Reasons for undergoing the procedure

In cases where your heart rhythm is irregular or very rapid, pharmacologic cardioversion may be necessary.

There are several reasons why your heart could beat abnormally, including:

  • Infections
  • Heart attack
  • Medications
  • Pulmonary embolism
  • Congestive heart failure
  • Lung diseases (e.g., COPD or emphysema)
  • Structural changes in your heart

These abnormal cardiac rhythms are treated by chemical cardioversion:

  • Atrial fibrillation (Afib)
  • Atrial flutter
  • Atrial tachycardia
  • Supraventricular tachycardia
  • Ventricular tachycardia
  • Ventricular fibrillation

Chemical cardioversion is frequently used by doctors. They apply it to several types of abnormal cardiac rhythms. Of all the abnormal heart rhythms, atrial fibrillation is the most prevalent.


Among the dangers of chemical cardioversion are:

  • You could develop a new arrhythmia or your current one could worsen.
  • It’s possible that you have a blood clot that results in a stroke.
  • Adverse effects, such feeling exhausted or sick to your stomach, are possible.
  • Some medications don’t start working right away.
  • If it is ineffective, catheter ablation or electrical cardioversion may be required.

In the long run, medications may only be 50% effective and may not work for everyone.

Call your emergency hotline if you have any unusual side effects from chemical cardioversion, such as the following.

  • Heart palpitations
  • Dizziness
  • Weakness
  • Sweatiness
  • Chest pain
  • An allergic reaction
  • Difficulty breathing
  • Lightheadedness

Before the procedure

Which type of cardioversion is ideal for you will be determined by your doctor. Your doctor can decide to use an electrical cardioversion if your blood pressure is very low.

It is possible to get chemical or electrical cardioversion if your blood flow is good.

In certain cases, vagal maneuvers could be a third alternative for patients experiencing specific type of supraventricular tachycardia. There is no use of electricity or medications in these maneuvers. Nevertheless, their effectiveness is not guaranteed.

It’s essential to refrain from consuming any food or beverages for a duration of eight hours prior to a chemical cardioversion procedure.

A Transesophageal Echocardiography (TEE) may be necessary if you have an atrial arrhythmia. This is done by your provider to look for blood clots, which could be dislodged during a cardioversion.

Your doctor will want to know about all of your medications. This also applies to over-the-counter products, since they may interfere with prescription drugs used for chemical cardioversion.

Before undergoing chemical cardioversion, you should take anticoagulants, or blood thinners, for three weeks if atrial arrhythmias persist for more than two days. This reduces the possibility of blood clots. After your chemical cardioversion, you will need to continue taking anticoagulants for an additional four weeks in order to avoid blood clots, which can result in strokes.

During the procedure

You are going to be in an intensive care unit or another type of hospital room due to the possibility of developing additional abnormal cardiac rhythms. On the same day as your chemical cardioversion, you can be discharged from the hospital or hospitalized.

Your electrocardiogram (EKG) and blood pressure measurements should be monitored by your doctor. Additionally, in case they are needed, your cardiologist will be prepared with a defibrillator and sophisticated cardiovascular life support equipment.

Medication will be administered to you either by injection into your hand or arm, or by ingesting it. If a medicine doesn’t work after one dose, you might need to take it again.

Medications used for chemical cardioversion

The sort of abnormal cardiac rhythm you have will determine the medication your doctor prescribes. Certain medications used by doctors for chemical cardioversion are also used to treat congestive heart failure and elevated blood pressure.

Drugs used in chemical cardioversion may include:

  • Adenosine
  • Digoxin
  • Flecainide
  • Procainamide
  • Sotalol
  • Quinidine
  • Ibutilide
  • Amiodarone
  • Dronedarone
  • Propafenone
  • Metoprolol or other kinds of beta-blocker
  • Diltiazem or other kinds of calcium channel blocker

After the procedure

After your chemical cardioversion surgery, your doctor will continue to monitor you for the next 24 to 48 hours.


Cardioversion can usually swiftly return a person’s heartbeat to normal. Certain individuals require extra measures to maintain a normal heart beat.

Your doctor could advise you to modify your lifestyle in order to strengthen your heart health and prevent or cure diseases like high blood pressure that can lead to arrhythmias, or irregular heartbeats.