Electrical conversion of a tachyarrhythmia to restore normal sinus rhythm. This may be an emergency procedure (when the circulation is absent or severely compromised), semi-elective (when the circulation is compromised to a lesser degree), or elective (when synchronised cardioversion is performed to restore sinus rhythm for a non-compromising supraventricular tachycardia). Synchronisation requires initial connection of ECG leads from the patient to the defibrillator so that the shock is delivered on the R wave to minimise the risk of ventricular fibrillation. Newer, biphasic defibrillators require approximately half the energy setting of monophasic defibrillators.

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