Cardioversion, synchronized

If delays in synchronization occur and condition is critical, go immediately to unsynchronized shocks Cardioversion procedure... 

Resynchronize after each synchronized cardioversion before repeating above procedure... 

Synchronized Cardioversion Algorithm for the Management of Symptomatic Tachycardia... 

Direct current cardioversion is the process of administering a synchronized electrical shock to the chest. The purpose of DCC is to simultaneously depolarize all of the myocardial cells, resulting in interruption and termination of the multiple reentrant circuits and restoration of normal sinus rhythm. The initial energy level of the shock is 100 joules (J) if the DCC attempt is unsuccessful, successive cardioversion attempts maybe made at 200,300, and 360 J.14 Delivery of the shock is synchronized to the ECG by the cardioverter machine, such that the electrical charge is not delivered during... 

Hemodynamically unstable PSVT should be treated with immediate synchronized DCC, using an initial energy level of 50 J if the DCC attempt is unsuccessful, successive cardioversion attempts may be made at 100, 200,300, and 360 J.14... 

Direct current cardioversion The process of administering a synchronized electrical shock to the chest to simultaneously depolarize all of the myocardial cells, resulting in restoration of normal sinus rhythm. 

If no conversion with medications, contact medical command and consider elective synchronized cardioversion. Go to page 381... 

NOTE At any time if pt becomes unstable, immediately perform synchronized cardioversion, go to page 381) if PEA develops, go to page 380... 

Synchronized Electrical Cardioversion (Tachycardia w/ Pulses in Hemodynamic Instability) Adult... 

Early cardioversion may be necessary in patients with hemodynamic compromise (acute pulmonary edema, worsening angina, or hypotension) in relation to uncontrolled AF (flow chart). Synchronized, direct current cardioversion is more effective and preferable to pharmacologic cardioversion under these circumstances. Intravenous anticoagulation should precede and follow the cardioversion (Fig. 2). 

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