What energy is used to cardiovert Wide Regular rhythms (MVT)?

What energy is used to cardiovert Wide Regular rhythms (MVT)?

• A. 50 J
• B. 100 J
• C. 200 J
• D. 300 J

Answer: (B)

When a wide, regular tachycardia is actually monomorphic VT with a pulse, you treat it with synchronized cardioversion. The starting energy for this approach is 100 J on a modern biphasic defibrillator. Using a synchronized shock targets the VT rhythm at the moment of the R wave to reduce the risk of inducing another arrhythmia, while still delivering enough energy to terminate the tachycardia. If the first attempt doesn’t work, you increase the energy—typically to 200 J, then 300 J, and possibly 360 J depending on the device and protocol. The lower energy options are not appropriate as the initial shock, while higher energies would be used only if needed after the first attempt.

When a wide, regular tachycardia is actually monomorphic VT with a pulse, you treat it with synchronized cardioversion. The starting energy for this approach is 100 J on a modern biphasic defibrillator. Using a synchronized shock targets the VT rhythm at the moment of the R wave to reduce the risk of inducing another arrhythmia, while still delivering enough energy to terminate the tachycardia. If the first attempt doesn’t work, you increase the energy—typically to 200 J, then 300 J, and possibly 360 J depending on the device and protocol. The lower energy options are not appropriate as the initial shock, while higher energies would be used only if needed after the first attempt.