text: PROCEDURE: , Direct current cardioversion.,REASON FOR PROCEDURE: , Atrial fibrillation.,PROCEDURE IN DETAIL:  ,The procedure was explained to the patient with risks and benefits including risk of stroke.  The patient understands as well as her husband.  The patient had already a transesophageal echocardiogram showing no left atrial appendage thrombus or thrombus in the left atrium.  There was spontaneous echocardiogram contrast noticed.  The patient was on anticoagulation with Lovenox, received already 3 mg of Versed and 25 mcg of fentanyl for the TEE followed by next 2 mg of Versed for total of 5 mg of Versed.  The pads applied in the anterior and posterior approach.  With synchronized biphasic waveform at 150 J, one shock was successful in restoring sinus rhythm.  The patient had some occasional PACs noticed with occasional sinus tachycardia.  The patient had no immediate post-procedure complications.  The rhythm was maintained and 12-lead EKG was requested.,IMPRESSION:  ,Successful direct current cardioversion with restoration of sinus rhythm from atrial fibrillation with no immediate complication.cardiovascular / pulmonary, thrombus, atrium, echocardiogram, transesophageal, direct current cardioversion, atrial fibrillation, sinus rhythm, sinus, rhythm, cardioversion