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Doctor insights on: How Many Times Can You Perform Cardioversion To Revert Atrial Fibrillation To Normal Sinus Rhythm

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How many times can you perform cardioversion to revert atrial fibrillation to normal sinus rhythm?

How many times can you perform cardioversion to revert atrial fibrillation to normal sinus rhythm?

There is no limit: However, there is not much point in doing it repeatedly if the patient continues to go back into fibrillation especially if on medicine to maintain normal rhythm. Patients can do quite well even if in fibrillation as long as the heart rate is controlled with medication. ...Read more

Dr. Mark Ingerman
3 Doctors shared insights

Sinus (Definition)

In anatomy, a sinus is a cavity within a bone or other tissue. Most commonly found in the bones of the face and connecting with the nasal cavities. Sinus (anatomy), description of the general term paranasal sinuses, air cavities in the cranial bones, especially those near the nose, including: the maxillary sinuses, also called the maxillary antra and the largest of the ...Read more


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How many times can cardioversion be performed on an individual to revert atrial fib to normal sinus rhythm?

How many times can cardioversion be performed on an individual to revert atrial fib to normal sinus rhythm?

There is: No specific number or limit, however, if multiple cardioversions are needed it might be time to consider ablation or a change in medical therapy. ...Read more

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I am on Flecainide and Warfarin for Atrial Fibrillation and I am now in sinus rhythm. Do I also need Bisoperal Fumerate?

I am on Flecainide and Warfarin for Atrial Fibrillation and I am now in sinus rhythm. Do I also need Bisoperal Fumerate?

Maybe: Flecainide is a specific medication to prevent recurrence of atrial fib.Bisoprolol is a beta blocker and can prevent rapid heart rate if you go back to atrial fib although it is not the drug commonly use. You may have another reason that your doctor preferred this such as hypertension.Check with your prescribing doctor. It is always best to ask when given a prescription. ...Read more

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For an Atrial Fibrillation patient, how critical is it to have sinus rhythm restored within a short time, assuming the patient takes NOAC full time?

For an Atrial Fibrillation patient, how critical is it to have sinus rhythm restored within a short time, assuming the patient takes NOAC full time?

Afib begets Afib.: The longer you are in Afib the less likely you are to be able to be converted and maintained in NSR. It is not "critical" but certainly desirable to be restored to NSR as soon as possible. If you are fully compliant with your NOAC you could go for cardioversion at any time. No waiting required. ...Read more

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What is the loading oral dose cordarone (amiodarone) In old patient with atrial fibrillation returned to sinus rhythm and how to reduce its side effect?

What is the loading oral dose cordarone (amiodarone) In old patient with atrial fibrillation returned to sinus rhythm and how to reduce its side effect?

Amiodarone: There are a number of schemes to load but to obtain levels one uses 800 mg for 5 day, 600 mg for 5 days, and 400 mg maintenance for 3-6 months and then attempt to lower dose to 200 mg daily. Side effects are followed by monitoring thyroid, chest X-ray and liver function as well as sun screen ...Read more

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Do you think Atrial Fibrillation would improve with an ablation? Only remedy so far is cardioversion

Do you think Atrial Fibrillation would improve with an ablation? Only remedy so far is cardioversion

Yes: RF ablation for atrial fibrillation and/or atrial flutter in good hands ought to be curative. Factors that determine success: electrophysiologists experience and record of success, duration of AF; size and function of Left atrium. Good luck! ...Read more

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Does anyone know a person who had a cardioversion for atrial fibrillation?

I do: We perform cardioversions as an absolutely routine part of our practice in cardiac electrophysiology. It is a safe and well-tolerated procedure which can restore normal rhythm for many patients. ...Read more

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I have atrial fibrillation and am considering whether or not to have cardioversion?

I have atrial fibrillation and am considering whether or not to have cardioversion?

Cardioversion: The shorter the duration of atrial fibrillation the more effective cardioversion is at converting the rhythm. When underlying cardiac pathology like mitral insufficiency or stenosis is present, keeping the patient out of atrial fibrillation or converting the rhythm is quite problematic. The procedure is low risk for most people if they have been anticoagulated for several weeks beforehand as needed. ...Read more

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Can innapropriate sinus tachycardia lead to atrial fibrillation got to go to hospital monday for ECG my heart rhythm gone from normal to abnormal?

Can innapropriate sinus tachycardia lead to atrial fibrillation got to go to hospital monday for ECG my heart rhythm gone from normal to abnormal?

Not usually: This would be a bit odd. Usually fibrillation is the result of age, drinking, and diseases which exhaust or stretch out the atria. Inappropriate sinus tach usually doesn't directly result in afib. When it went to "abnormal" are you sure that was to fib? Did they get an ekg? Could well be flutter too, which can occasionally be mistaken for fib. ...Read more

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Why do you take betapace, xocor, digoxin, and Coumadin (warfarin) with atrial fibrillation and sinus tachycardia?

Why do you take betapace, xocor, digoxin, and Coumadin (warfarin) with atrial fibrillation and sinus tachycardia?

Prevent stroke: Actually atrial fibrillation and sinus tachycardia are two completely different heart rhythms. None of these drugs would be of any use for sinus tachycardia. In atrial fibrillation, Betapace may restore a normal rhythm. Digoxin can help keep the heart rate down. Coumadin (warfarin) reduces the risk of stroke. Zocor also reduces stroke risk in some patients, but this is unrelated to the atrial fib. ...Read more

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If atrial fibrillation with sick sinus syndrome changes from intermittent to continuous, is further treatment needed? Taking Coversyl & Pradaxa now.

If atrial fibrillation with sick sinus syndrome changes from intermittent to continuous, is further treatment needed? Taking Coversyl & Pradaxa now.

AF: This discussion should be with your doctor who knows you and your entire situation. In general if maintaining sinus rhythm is no longer realistic, we still need to continue rate control and usually anticoagulation. These treatments however need to be patient specific. ...Read more

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My husband's atrial fibrillation seems to have progressed. He's breathing very rapid and loud while sleeping, has higher heart rates, sick sinus syndr?

My husband's atrial fibrillation seems to have progressed. He's breathing very rapid and loud while sleeping, has higher heart rates, sick sinus syndr?

Sleep apnea and AFib: There is a well known association between hypoxemia (low circulating oxygen in blood) and stress on heart manifesting as arrhythmia. In ur husbands case, loud breathing may be snoring. Have him see a reputable pulmonologist for eval and treatment of sleep apnea if he has it. Treat underlying cause of what may be worsening his AF. Cardiologist ought to coordinate with pulmonary doc. ...Read more

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I have been to the ER for a rapid heartbeat. Sometimes it's diagnosed as sinus tachycardia and sometimes atrial fibrillation. I have tried cardyzeme and metopral without much success. What happens if I don't seek treatment next time?

I: I agree with dr. Guyton's excellent and thorough answer and would like to emphasize that with atrial fibrillation there are two main issues:
1) heart rate - a fast heart rate is typically what most people present with, and typically can be managed with medications to control heart rate such as the two you described, although there are others. Sustained high heart rates are not good for the heart, but as long as you are not having chest pain, shortness of breath, dizziness, or loss of consciousness then you can call your physician before rushing to the er.
2) stroke - afib presents a very real increase risk of stroke if not properly treated. For this reason, an accurate diagnosis is a must, and if it is indeed afib the you should discuss with your physician whether you are high enough risk to require blood thinners such as Coumadin (warfarin) or pradaxa. This is a long term risk so can be discussed in the outpatient setting with your docotor or a cardiologist. ...Read more

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I have a Holter test result: Normal sinus rhythm with occasional premature atrial complexes and rare premature ventricular complexes, please explain.

This is a very: Normal report. It means that your heart beat originates from the appropriate place most of the time but you have occasional extra heart beats that come from the top as well as rare ones that come from the bottom of your heart. We ALL do! No worries. ...Read more

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Any idea what this means? Normal sinus rhythm. Possible Left atrial enlargement Cannot rule out Anterior infarct. Abnormal EKG

Any idea what this means? Normal sinus rhythm. Possible Left atrial enlargement Cannot rule out Anterior infarct. Abnormal EKG

Could be normal.: Depends upon your clinical situation. EKG's are not very predictive if they are done without a specific purpose in mind. If you have not had any symptoms and this EKG was done as part of a "routine" then it is very likely just an interesting finding without a physical meaning. You should discuss this with the person who ordered the test. ...Read more

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Normal sinus rhythm. Possible lt atrial enlargement. Cannot rule out Ant infarct, age undetermined. Abnormal ECG. Had pain in left chest and arm.

Normal sinus rhythm. Possible lt atrial enlargement. Cannot rule out Ant infarct, age undetermined. Abnormal ECG. Had pain in left chest and arm.

Need work up: You have to see your doctor for further evaluation. Echocardiogram and stress test are most likely indicated to rule out coronary heart disease. You are young, there fore it is not very likely unless you smoke, have family history of coronary heart disease at relatively young age, have high cholesterol. Check with your doctor whether your Levothyroxine dose is not high for you. ...Read more

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I am in sinus rhythm with Flecainide. I really don't want it long term. Could I come of it, go back into AF and then have an electrical cardioversion?

Yes: You can stop flecainide anytime but consult with your MD first as there are options. You can take loading dose of Flecainide if you go back to a fib and if it does not convert back to sinus, then you can have a cardioversion. I assume you are receiving anticoagulation. If atrial fib is very bothersome when it happens, you can be a candidate for ablation Or if you feel ok with it you can stay in AF ...Read more

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If I have experienced atrial fibrillation recently but am back in rhythm should I go on a international trip or cancel.

If I have experienced atrial fibrillation recently but am back in rhythm should I go on a international trip or cancel.

Depends: This really depends on a few things, including what your symptoms were like in atrial fibrillation, whether your doctor is changing your medications, and how you are feeling now. In general it is best to check with your doctor, but if your heart rate was ok, your symptoms were mild or nonexistent, and your stroke risk is appropriately addressed with anticoagulation, it would probably be ok to go. ...Read more

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I have atrial fibrillation but the blood work and ECG are normal. How is that?

I have atrial fibrillation but the blood work and ECG are normal. How is that?

Fleeting AF: Many people are not in atrial fibrillation continuously but, rather, on and off. An ECG is a 12 second strip - you may have been in an "off" period (in normal rhythm) during the ECG recording. Blood work is usually not affected in atrial fibrillation. ...Read more

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What is the success rate for the "firm" procedure for atrial fibrillation and are there any additional risks having it done over a normal ablation

Alternate technique: My understanding is that FIRM (focal impulse and rotor modulation) ablation is, perhaps, a more advanced ablation system using a very sophisticated catheter that, purportedly, maps locations/rotors that seemingly could trigger & sustain AF. Success up to 80% in controlling AF for 2 years is reported, better than with standard ablation. Risks should be similar. Careful case selection is important! ...Read more

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Always had heart palps, had tests years ago all normal. Lately palps increased. Can Atrial Fibrillation just develop? Or do you always have it?

Atrial fibrillation: AFib can 'just develop'. If you have anxiety disorder, it will magnify any minimal extrasystoles you may have. There are many monitoring devices, event recorders even implantable but your doctor can best evaluate whether you need aggressive attempts at seeing if you have an arrhythmia and what it is. ...Read more

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Would atrial fibrillation show up on an EKG or is a holter monitor needed to diagnosis? I am convinced I have af but my EKG was normal.

Would atrial fibrillation show up on an EKG or is a holter monitor needed to diagnosis? I am convinced I have af but my EKG was normal.

It depends....: Atrial fibrillation is an abnormal heart rhythm which occurs mostly in the elderly. It can be persistent or paroxysmal (intermittent). An ECG shows the heart rhythm at the time it is being done. An abnormal rhythm would be seen only if the heart was in that rhythm at that time. A holter monitor would follow the rhythm over a period of time >24hrs and could show if it happens intermittently. ...Read more

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In a fit, healthy 18 year old. What's the worst that could happen if I have atrial fibrillation? Normal echocardiogram, ekg, but didn't have palps during

Nothing: Other than the sensation of palpitation, atrial fibrillation in young healthy persons are benign. Since in this age group the arrhythmia is often associated with a very rapid heart rate they often require treatment to control heart beat or intervention to convert them back to regular rhythm ...Read more

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What's the underlying causes of atrial fibrillation? Echo done was normal.

Several: Look out for left atrial enlargement or mitral valve narrowing/leakiness on echocardiogram, which would indicate structural heart problems. If echo is totally normal, rule out hyperthyroidism, sleep apnea, excessive alcohol intake. ...Read more

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How dangerous could atrial fibrillation be in a healthy, very fit 18 year old with no other problems? Normal echocardiogram, ekg, and stress test

Not likely: Atrial fibrillation is not as common in young individuals as in elderly. Sometimes benign arrhythmias are over diagnosed as atrial fibrillation. In your case how was your atrial fibrillation diagnosed? Otherwise atrial fibrillation remains a significant medical condition with a variety of possible complications, the most common being stroke. ...Read more

Rhythm (Definition)

Rhythm "any regular recurring motion, symmetry may be generally defined as a movement marked by the regulated succession of strong and weak elements, or of opposite or different conditions, this general meaning of regular recurrence or pattern in time may be applied to a wide variety of cyclical natural phenomena having a periodicity or frequency of anything microseconds ...Read more


Dr. John Garner
1,834 Doctors shared insights

Atrial Fibrillation (Definition)

A heart condition, in which the electrical activity of the heart is abnormal. This abnormal electrical signal causes the heart muscle to contract when it is not supposed to and thus blood is ...Read more