Successful external cardioversion for ventricular tachycardia using 2 Joules

We present a patient with recurrent sustained monomorphic ventricular tachycardia following myocardial infarction, refractory to drug therapy. He has been reluctant to have an implantable cardioverter-defibrillator, but responds to very low energy transthoracic direct current cardioversion administered via external pacing electrodes under sedation. The use of very low energies may avoid shock-induced myocardial damage in patients with recurrent ventricular tachycardia.