Harefuah
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Transthoracic electrical cardioversion (ECV), traditionally using monophasic waveform (MW) shock, has an important role in the treatment of symptomatic atrial flutter (AFI). Biphasic waveform (BW) shock has been demonstrated to be more successful than MW shock for termination of atrial fibrillation, but data about its use for ECV of AFI are limited. ⋯ There were no significant differences in the success rates of conversion of atrial flutter to sinus rhythm by BW or MW shock. We recommend 50 joules for starting energy of ECV of AF1 regardless of waveforms type.