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August 1, 1986

The New Era of Cardioversion

JAMA. 1986;256(5):628-629. doi:10.1001/jama.1986.03380050096029

WITH the publication of this important article, describing the first clinical application of synchronized capacitor direct current (DC) discharge, the era of elective electrical treatment of cardiac arrhythmias began. The development of this method, so commonly used we tend to take it for granted, is a paradigm of the brilliant wedding of clinical acumen and profound understanding of good basic science, when chance did indeed favor the prepared mind. Its history is worth reviewing.

A Signal Patient  On Dec 1, 1960, a 59-year-old man was admitted to Bernard Lown's service at the Peter Bent Brigham Hospital in Boston with chief complaints of sweating, palpitations, and shortness of breath. Eleven years before, he had sustained an acute myocardial infarction. Several years later, episodes of atrial and ventricular rhythm disturbances began. The night before this admission, he had developed severe palpitations. Treatment elsewhere over the next 24 hours with 3.5 g of