Techniques are provided for generating plateau-shaped cardioversion shocks having reduced lead edge voltages. The reduced leading edge voltages are provided primarily to reduce the likelihood that any cardiac pain receptors will fire twice during a single cardioversion shock. Other techniques described herein relate to the generation of plateau-shaped shocks without reduced leading edge voltages. Still other techniques pertain to the generation of pre-pulse pain inhibition (PPI) pulses, particularly PPI pulses having chevron-shaped waveforms.