What is the role of cardioversion in the treatment of atrial flutter?

Updated: Nov 09, 2018
  • Author: Jesse Borke, MD, FACEP, FAAEM; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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If the patient is unstable (eg, hypotension, poor perfusion), synchronized direct-current (DC) cardioversion is the initial treatment of choice.

Cardioversion may be successful with energies as low as 25 joules, but 100 joules is usually successful and is therefore a reasonable initial shock strength. Higher energy levels are occasionally required.

If the electrical shock results in atrial fibrillation, a second shock at a higher energy level is used to restore normal sinus rhythm.

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