Direct current cardioversion is a critical tool for intensivists, but elective use requires careful patient selection and proper technique, while addressing arrhythmia precipitants may be safer than repetitive futile attempts.
May guide selective DCCV use in ICU; leaves open prospective trials on trigger management versus repeated shocks.
Direct current cardioversion/defibrillation is an important part of the intensivist's armamentarium. Emergent application may be lifesaving. Elective cardioversion should be used cautiously, with attention to patient selection and proper techniques. Repetitive, futile attempts at direct current cardioversion should be avoided. Reducing or eliminating arrhythmia precipitants may be safer and more effective than this more dramatic intervention.
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Trohman et al. (2000) studied this question.
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