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Severe burns result in a profound hypermetabolic response. Catecholaminergic surges secondary to the burn injury itself, particularly if superimposed on premorbid cardiac disease, can result in cardiac arrhythmias. If unstable, these cardiac rhythm disturbances necessitate immediate cardioversion to regain normal sinus rhythm. Because of the high impedance at the skin-paddle interface, superficial cutaneous burns have been known to develop secondary to cardioversion. The authors describe a novel case of the subsequent local progression of a previously sustained superficial flame burn to full-thickness burn injury after cardioversion.