When is synchronized cardioversion typically used?

Synchronized cardioversion is a specifically targeted treatment option used for addressing certain arrhythmias in stable patients. It is most commonly indicated for conditions such as supraventricular tachycardia (SVT) and atrial fibrillation (Afib) with rapid ventricular response (RVR). The procedure works by delivering a controlled electrical shock that is synchronized to the R-wave of the QRS complex, thus minimizing the risk of inducing ventricular fibrillation, which can happen if the shock is delivered during the vulnerable period of the cardiac cycle.

In cases of SVT, synchronized cardioversion can restore normal rhythm by interrupting the reentrant circuit responsible for the rapid heart rate. Similarly, in Afib with RVR, it helps control the heart rate and restore a more stable sinus rhythm, especially when the patient is symptomatic.

Other scenarios such as pulseless ventricular tachycardia (Vtach) typically require immediate defibrillation rather than synchronized cardioversion, as the heart is not effectively pumping blood, making synchronized timing unnecessary. Immediate defibrillation is also critical when an immediate life-threatening arrhythmia is present. While high-energy shocks can be administered in different contexts, synchronized cardioversion is intended to provide lower energy shocks