What are the steps of an elective cardioversion?

Check list. I'm assuming this is for atrial fib? Full anticoagulation for at least 4 weeks. Nothing by mouth 4 hours before. Pads and monitor leads placed on chest and/or back. Iv line secured. Iv sedation. Synchronized cardioversion. Supervision till awake. Home.
1, 2, 3. 1) we bring you into the procedural area and review your medical history. This lets us pick the best anesthesia strategy. 2) we perform an echocardiogram (tee) if necessary to exclude any clots that might fling loose when we deliver the shock 3) we put you fully to sleep, even if only briefly and deliver the shock that will (hopefully) restore normal rhythm. *) bonus 4: you go home!
Several important. Assuming it's for atrial fibrillation (af), it depends on duration of the af. If it's been a few days, anticoagulants to avoid systemic embolization, possible echocardiography to look for clots and determine chamber sizes for prognostic purposes. Good informed consent, modest fasting, establishing an IV for the medications, possibly an anesthesiologist, synch testing, and a good cardiologist!