Precautions and complications

Prior to cardioversion it is important to ensure that:

• antiarrhythmic drug concentrations e.g. digoxin are within the therapeutic window (some stop drugs several days before cardioversion)
• the serum potassium is within normal limits

Complications

• arrhythmias e.g. ventricular tachycardia, ventricular fibrillation
  
  
• thromboembolism:
  • this risk is minimised by formal anticoagulation of patients with long-standing atrial fibrillation or ventricular aneurysm
  • anticoagulation should be for a period of 1 month before the cardioversion and maintained for a further period of 1 month after the cardioversion
    
    
• chest wall burns - this is prevented by the proper use of saline gel pads