For atrial flutter, what is the recommended energy level for synchronized cardioversion?

The recommended energy level for synchronized cardioversion in the case of atrial flutter is 70-120 joules. This range is considered effective for delivering the electrical shock needed to reset the heart's rhythm without causing significant harm to the myocardium.

Using synchronized cardioversion is essential in atrial flutter because it allows for the shock to be timed with the R-wave of the QRS complex, minimizing the risk of inducing ventricular fibrillation, which could occur if the shock is delivered during the vulnerable period of the cardiac cycle.

The choice of energy level is based on evidence that indicates this range strikes the right balance between efficacy and safety, ensuring successful conversion back to a normal sinus rhythm while minimizing the risk of complications associated with higher energy levels.