Ventricular tachycardia (VT) may or may not generate a pulse. Therefore, it is crucial to assess the hemodynamic status before ACLS resuscitative measures are begun. If the patient has a pulse, is conscious, and has only mild complaints of palpitations, mild chest discomfort, weakness, and/or anxiety, immediate electrical cardioversion is not required. On the other hand, if the patient exhibits signs of instability, including syncope, severe chest pain, or marked hypotension, then cardioversion should proceed immediately after appropriate sedation is delivered.