| Impedance compensated biphasic waveforms for transthoracic cardioversion of atrial fibrillation: a multi-centre comparison of antero-apical and antero-posterior pad positions. | |
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MedLine Citation:
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PMID: 15824079 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: To compare the success rate for transthoracic direct current cardioversion (DCC) of atrial fibrillation (AF) with antero-posterior (AP) and antero-apical (AA) electrode positions using an impedance compensated biphasic (ICB) waveform. METHODS AND RESULTS: Three-hundred and seven patients [mean age 66 (SD+/-13), 195 male] with AF were recruited in three centres. Patients were randomized to an AA (n=150) or AP (n=144) pad position. Thirteen patients with implanted pacemakers were defaulted to the AP pad position. Cardioversion was performed using an ICB waveform with a 70, 100, 150, and 200 J energy selection protocol. If the fourth shock was unsuccessful, the pads were crossed over to the alternative position for a final 200 J shock. Shock 1 was successful in 54/150 (36%) AA and 45/144 (31%) AP patients, whereas success was achieved by shock 2 in 99/150 (66%) AA and 74/144 (51%) AP, by shock 3 in 123/150 (82%) AA and 109/144 (76%) AP, and by shock 4 in 143/150 (95%) AA and 127/144 (88%) AP and after cross-over in 144/150 (96%) AA and 135/144 (94%) AP. Overall success rate was higher than expected at 95%. Pad position was not associated significantly with success. There was a trend towards an improved outcome with the AA configuration (P=0.05). CONCLUSION: The influence of pad position for DCC of AF may be less pertinent with ICB waveforms than with monophasic waveforms. |
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Authors:
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Simon J Walsh; David McCarty; Anthony J J McClelland; Colum G Owens; Tom G Trouton; Mark T Harbinson; Siobhan O'Mullan; Andrew McAllister; Brian M McClements; Mike Stevenson; Gavin W N Dalzell; A A Jennifer Adgey |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2005-04-11 |
Journal Detail:
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Title: European heart journal Volume: 26 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2005 Jul |
Date Detail:
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Created Date: 2005-06-20 Completed Date: 2005-10-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 1298-302 Citation Subset: IM |
Affiliation:
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Regional Medical Cardiology Centre, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Atrial Fibrillation / physiopathology, therapy* Cardiography, Impedance Electric Countershock / instrumentation*, methods Electrodes Female Humans Male Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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