Direct current cardioversion: indications, techniques, and recent advances.

Direct current cardioversion/defibrillation is an important part of the intensivist's armamentarium. Emergent application may be lifesaving. Elective cardioversion should be used cautiously, with attention to patient selection and proper techniques. Repetitive, futile attempts at direct current cardioversion should be avoided. Reducing or eliminating arrhythmia precipitants may be safer and more effective than this more dramatic intervention.