This is also known as direct current (DC) cardioversion. Electrical shock is synchronized (perfectly timed) to convert an abnormal rhythm to a normal sinus rhythm. DC cardioversion is performed in the hospital in a monitored setting.
#Indications_for_electrical_cardioversion
include the following:
*Supraventricular tachycardia (atrioventricular nodal reentrant tachycardia [AVNRT] and atrioventricular reentrant tachycardia [AVRT])
*Atrial fibrillation
*Atrial flutter (types I and II)
*Ventricular tachycardia with pulse
Any patient with reentrant tachycardia with narrow or wide QRS complex (ventricular rate >150 bpm) who is unstable (eg, ischemic chest pain, acute pulmonary edema, hypotension, acute altered mental status, signs of shock)
#Contraindications_of_cardioversion:
*Dysrhythmias due to enhanced automaticity, such as in digitalis toxicity and catecholamine-induced arrhythmia
*Multifocal atrial tachycardia
#For dysrhythmias due to enhanced automaticity such as in digitalis toxicity and catecholamine-induced arrhythmia, a homogeneous depolarization state already exists. Therefore, cardioversion is not only ineffective but is also associated with a higher incidence of postshock ventricular tachycardia/ventricular fibrillation (VT/VF).
#Contraindications_of_cardioversion:
*Dysrhythmias due to enhanced automaticity, such as in digitalis toxicity and catecholamine-induced arrhythmia
*Multifocal atrial tachycardia
#For dysrhythmias due to enhanced automaticity such as in digitalis toxicity and catecholamine-induced arrhythmia, a homogeneous depolarization state already exists. Therefore, cardioversion is not only ineffective but is also associated with a higher incidence of postshock ventricular tachycardia/ventricular fibrillation (VT/VF).