General Cardioversion Energy Levels

Cardiac Rhythm

Energy Level (joules)

Atrial fibrillation

100-200J (monophasic waveform)
100-120J (biphasic waveform)
Stepwise increase for subsequent shocks

Atrial flutter

50-100J Mono or Biphasic
Stepwise increase for subsequent shocks

Supraventricular tachycardia due to reentry

50-100J mono or Biphasic
Stepwise increase for subsequent shocks

Ventricular tachycardia (VT) (monomorphic)

100J Monophasic
75J Biphasic

Stepwise increase for subsequent shocks

VT (polymorphic)

Sync if you can. if you can’t, 360J unsynchronized monophasic shocks
200J if biphasic