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