How To Do Synchronized Cardioversion In An Adult

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The electrodes (pads or paddles) used for cardioversion may be placed anteroposteriorly (along the left sternal border over the 3rd and 4th intercostal spaces and in the left infrascapular region) or anterolaterally (between the clavicle and the 2nd intercostal space along the right sternal border and over the 5th and 6th intercostal spaces at the apex of the heart). After synchronization to the QRS complex is confirmed on the monitor, a shock is given.
The most appropriate energy level varies with the tachyarrhythmia being treated. Cardioversion and defibrillation efficacy increases with use of biphasic shocks, in which the current polarity is reversed part way through the shock waveform.
Filmed on location and with the assistance of the Einstein Center for Clinical Competence, Einstein Healthcare Network, Charles Bortle, EdD, Director.
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