Definition
Synchronized cardioversion is employed for hemodynamically unstable supraventricular tachycardias (atrial fibrillation / atrial flutter, AV junctional tachycardia, multifocal atrial tachycardia, and paroxysmal reentrant tachycardia).
New onset atrial flutter often requires only 50 J (monophasic or biphasic). For atrial fibrillation and PSVT in adults start with 100-120 J for biphasic waveforms (100-200 J with monophasic). Escalate the doses as needed.
For SVT in pediatric patients, start with 0.5 J/kg and double if necessary.
Synchronized Cardioversion (Adults)
- Atrial fibrillation: start with 100-120 J for biphasic waveforms (100-200 J with monophasic)
- Atrial flutter: 50 J (mono/bi) if new onset
- PSVT: start with 100-120 J for biphasic waveforms (100-200 J with monophasic)
Synchronized Cardioversion (Pediatrics): 0.5 J/kg and double if necessary
Subspecialty
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See Also:
Sources
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Miller, RD et al. Miller’s Anesthesia, 7th edition, Churchill Livingstone: p 2979-2981. 2009.
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Hines RL and Marschall, KE. Stoelting’s Anesthesia and Co-Existing Disease, 5th Ed, Saunders: Chapter 18. 2008.
