What are the indications for use of external synchronized electrical cardioversion?

Updated: Nov 28, 2018
  • Author: Sean C Beinart, MD, MSc, FACC, FHRS; Chief Editor: Jose M Dizon, MD  more...
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Based on advanced cardiac life support (ACLS) guidelines, any patient with a narrow or wide QRS complex tachycardia (ventricular rate >150 beats per minute [bpm]) who is unstable (eg, chest pain, pulmonary edema, lightheadedness, hypotension) should be immediately treated with synchronized electrical cardioversion. [7]  Synchronization to an R or S wave prevents the delivery of a shock during the vulnerable period of cardiac repolarization when ventricular fibrillaiton (VF, vfib) can be induced.

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