Background: In biphasic external cardioversion(CV) of atrial fibrillation(AF), the influence of different electrode positions on efficacy and incidence of early recurrent atrial fibrillation is not known. This study c...Background: In biphasic external cardioversion(CV) of atrial fibrillation(AF), the influence of different electrode positions on efficacy and incidence of early recurrent atrial fibrillation is not known. This study compared anteroposterior(AP) vs anterolateral(AL) electrode positioning. Methods: Consecutive patients referred for CV of persistent AF were randomized either to an AP or an AL electrode position. Biphasic external CV was performed with standardized electrode positions and rising energy delivery. Results: Both groups(N=123, mean age 66 years, 71%male, 83%with structural cardiovascular disease or hypertension) did not differ concerning age, sex, body mass index, chronic antiarrhythmic therapy, duration of AF, left ventricular ejection fraction, and left atrial diameter. Cumulative success rates were comparable(AP 94.9%vs AL 95.2%, P=ns). First-shock efficacy did not differ(AP 78.3%vs AL 74.6%, P=ns). Early recurrent atrial fibrillation(AF relapse< 1 minute after successful CV) occurred in 8.1%(AP 11.6%vs AL 4.8%, P=ns). Mean number of shocks was 1.3 per patient with the AP configuration and 1.4 per patient with the AL configuration(P=ns). Mean cumulative energy delivery was also comparable(AP 171 WS vs AL 198 WS, P=ns). Conclusions: Both electrode positions are similar in biphasic external CV of AF with regard to acute success and early recurrent atrial fibrillation. Also, the number of shocks needed and energy delivery are comparable with both electrode configurations.展开更多
Biphasic shocks are more effective than damped sine wave monophasic shocks for transthoracic cardioversion(CV) of atrial fibrillation(AF), but the optimal protocol for CV with biphasic shocks has not been defined. We ...Biphasic shocks are more effective than damped sine wave monophasic shocks for transthoracic cardioversion(CV) of atrial fibrillation(AF), but the optimal protocol for CV with biphasic shocks has not been defined. We conducted a prospective, randomized study of 120 consecutive patients with persistent AF to delineate the dose-response curve for CV of AF with a biphasic truncated exponential shock waveform and to identify clinical predictors of shock efficacy. Our data suggest that the initial shock energy for CV with this waveform should be 200 J if the patient weighs< 90 kg and 360 J if the patient weighs ≥90 kg.展开更多
文摘Background: In biphasic external cardioversion(CV) of atrial fibrillation(AF), the influence of different electrode positions on efficacy and incidence of early recurrent atrial fibrillation is not known. This study compared anteroposterior(AP) vs anterolateral(AL) electrode positioning. Methods: Consecutive patients referred for CV of persistent AF were randomized either to an AP or an AL electrode position. Biphasic external CV was performed with standardized electrode positions and rising energy delivery. Results: Both groups(N=123, mean age 66 years, 71%male, 83%with structural cardiovascular disease or hypertension) did not differ concerning age, sex, body mass index, chronic antiarrhythmic therapy, duration of AF, left ventricular ejection fraction, and left atrial diameter. Cumulative success rates were comparable(AP 94.9%vs AL 95.2%, P=ns). First-shock efficacy did not differ(AP 78.3%vs AL 74.6%, P=ns). Early recurrent atrial fibrillation(AF relapse< 1 minute after successful CV) occurred in 8.1%(AP 11.6%vs AL 4.8%, P=ns). Mean number of shocks was 1.3 per patient with the AP configuration and 1.4 per patient with the AL configuration(P=ns). Mean cumulative energy delivery was also comparable(AP 171 WS vs AL 198 WS, P=ns). Conclusions: Both electrode positions are similar in biphasic external CV of AF with regard to acute success and early recurrent atrial fibrillation. Also, the number of shocks needed and energy delivery are comparable with both electrode configurations.
文摘Biphasic shocks are more effective than damped sine wave monophasic shocks for transthoracic cardioversion(CV) of atrial fibrillation(AF), but the optimal protocol for CV with biphasic shocks has not been defined. We conducted a prospective, randomized study of 120 consecutive patients with persistent AF to delineate the dose-response curve for CV of AF with a biphasic truncated exponential shock waveform and to identify clinical predictors of shock efficacy. Our data suggest that the initial shock energy for CV with this waveform should be 200 J if the patient weighs< 90 kg and 360 J if the patient weighs ≥90 kg.
