Editing Cardioversion (section)

== Electrode pad placement ==
Pad placement for electrical cardioversion a cardiac arrhythmia may be either anterior-posterior or anterior-lateral. In an anterior-posterior setup one pad is placed on the chest and the other pad is placed on the back. In an anterior-lateral setup, one pad is placed on the chest and the other pad is placed along the left midaxillary line. Choosing the right pad placement can be an important aspect when measuring the success of electrical cardioversion. For example, the anterior-posterior pad positioning is commonly used when attempting to restore an atrial arrhythmia as the vector between the pads predominately runs through the atria. The anterior-lateral pad positioning may be used when attempting to restore pulseless ventricular tachycardia or ventricular fibrillation as there may not be enough time or strength to apply an electrode the patient's back.

=== Anterior-Posterior pad placement ===

The anterior pad should be placed inferior to the right clavicle while also being vertically centered over at the level of the right 4th intercostal space. The posterior pad should be placed just lateral to the left side of the spine and vertically centered at the level of T7.<ref name=":0">{{cite journal | vauthors = Kirchhof P, Eckardt L, Loh P, Weber K, Fischer RJ, Seidl KH, Böcker D, Breithardt G, Haverkamp W, Borggrefe M | display-authors = 6 | title = Anterior-posterior versus anterior-lateral electrode positions for external cardioversion of atrial fibrillation: a randomised trial | journal = Lancet | volume = 360 | issue = 9342 | pages = 1275–1279 | date = October 2002 | pmid = 12414201 | doi = 10.1016/S0140-6736(02)11315-8 | s2cid = 25083798 }}</ref><ref name=":1">{{cite journal | vauthors = Botto GL, Politi A, Bonini W, Broffoni T, Bonatti R | title = External cardioversion of atrial fibrillation: role of paddle position on technical efficacy and energy requirements | journal = Heart | volume = 82 | issue = 6 | pages = 726–730 | date = December 1999 | pmid = 10573502 | pmc = 1729223 | doi = 10.1136/hrt.82.6.726 }}</ref> The inferior angle of the scapula can be used as a reference for the level of T7.

=== Anterior-Lateral pad placement ===

The anterior pad should be placed inferior to the right clavicle while also being vertically centered over at the level of the right 4th intercostal space. The lateral pad should be placed along the left midaxillary line at the level of the left 5th intercostal space.<ref name=":0" /><ref name=":1" /> The left nipple can be used as a reference for the level of the left 4th intercostal space. From here, the midaxillary 5th intercostal space is identified by moving inferiorly one intercostal space and laterally towards the midaxillary line.