What is the role of synchronized electrical cardioversion in the treatment of ventricular tachycardias?

Updated: Nov 28, 2018
  • Author: Sean C Beinart, MD, MSc, FACC, FHRS; Chief Editor: Jose M Dizon, MD  more...
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Treatment strategies for other ventricular tachycardias include the following:

  • Patients who do not respond to intravenous medications in treating stable monomorphic ventricular tachycardia associated with acute coronary syndrome or acute myocardial infarction should be initially treated with 50 to 100 joules of synchronized shocks. If no response to low-energy shock is noted, then a 200-joule shock should be administered, followed by 300- and 360-joule shocks as needed.

  • In unstable ventricular tachycardia, unsynchronized shocks should be delivered. Biphasic defibrillators do not require escalating energy, but three sequential shocks of 150 joules should be used.

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