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INTRODUCTION
External direct current cardioversion (DCC) is the application of a brief pulse of direct electrical current across the chest wall of a patient with an appropriate rapid dysrhythmia, causing momentary depolarization of most cardiac cells. Synchronized cardioversion refers to an electrical energy discharge synchronized with the QRS complex, avoiding energy delivery in the early phase of repolarization when the ventricular myocardium is susceptible to ventricular fibrillation (VF). Unsynchronized cardioversion refers to an unsynchronized discharge of energy and is only recommended for extremely unstable patients. DCC is usually effective almost immediately, has few side effects, and is often more successful than pharmacological therapy.


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