If you have atrial fibrillation, atrial flutter or atrial tachycardia continuously for a period of time, one procedure we may recommend is a cardioversion. This procedure consists usually of an electrical shock delivered on command. 

In some specific situations, cardioversion is achieved by administration of an intravenous medication in order to restore sinus (regular) rhythm. The highest efficacy, close to 90%, is achieved with electrical cardioversion. In rare situations, emergency electrical cardioversion is performed for patients who develop ventricular tachycardia.

This procedure is simply a resetting of the heart back to normal from the arrhythmia and does not guarantee maintenance of sinus rhythm.

In order to perform this procedure, you have to be on therapeutic anticoagulation for at least 4 weeks prior. 

If you have not been on anticoagulation, or if the anticoagulation has not been consistent for the past month, one of our cardiology colleague will perform another procedure, a trans-esophageal echocardiogram (TEE) (a test that uses high-frequency sound waves to obtain pictures of your heart) to make sure that there are no clots inside your heart, which would preclude the cardioversion.