69yr old male, known case of anterior mediastinal mass with myasthenia gravis and type II diabetes mellitus was admitted with complaints of weakness in all the four limbs and progressively increasing breathlessness on lying down in the left lateral position. Excision of the mass was done under general anaesthesia. Intra operatively, patient had two cardiac arrests which were managed successfully using external defibrillator pads for direct cardiac shock. Use of external defibrillator paddles for internal cardiac shock has never been reported and will be discussed.