Pharmaceutical Cardioversion

Pharmaceutical cardioversion is the use of medicine to convert an abnormal heart rhythm back to normal. Drugs may be used when the heart rhythm is not dangerous and vital signs such as blood pressure stay in the normal range. Drugs may be used first to treat a rhythm such as atrial fibrillation, when the beats starting in the top part of the heart are fast and not regular. You may have noticed it only because you had mild shortness of breath, were tired, dizzy, or felt your heart beating fast.


Your caregiver can tell you have an irregular heart rhythm by listening to your heart, feeling your pulse or by looking at an electrocardiogram (EKG). An EKG is a tracing of the electrical activity of your heart at that very moment.


  • Let your doctor know about every medicine you are taking, including vitamins, herbs, aspirin and eye drops.

  • You may be started on blood thinners because clots may form in the top chambers of the heart when it is not beating normally. These clots may travel to your brain or lungs when the rhythm is normal again and cause problems.

  • Take all medicines exactly as directed, especially blood thinners.

  • Follow instructions for getting blood tests and scheduling more exams.


  • You may have to stay in the hospital for a few days so your heart rhythm can be watched all the time.

  • There are several drugs that may be used, depending upon the exact rhythm of your heart.

  • It may take more than one drug or a combination before the rhythm changes.

  • If medications do not work, electrical cardioversion may be employed. This involves putting you briefly to sleep, and applying two paddles to the front of your chest to deliver a quick electrical current. This is "resets" your heart rhythm back to normal.

  • Once your heart rhythm is normal again, you may still be placed on medications to increase your chances of remaining in a regular heart rhythm.


  • You develop chest pain.

  • You develop nausea and vomiting or begin sweating markedly.

  • You become lightheaded, dizzy or faint.

  • You develop problems with your vision or thinking.

  • There is a change in your pulse and your heart beats are fast or no longer regular.