Synchronized electrical cardioversion

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