Medicina
-
Randomized Controlled Trial Comparative Study
[Impact of electrical shock waveform and paddle positions on efficacy of direct current cardioversion for atrial fibrillation].
Direct-current electrical cardioversion is the main method for the conversion of atrial fibrillation. Its success depends on many factors. In several studies, biphasic shock waveforms have been demonstrated to be superior to monophasic shocks for termination of atrial fibrillation; however, information about impact of paddle position is controversial. Initial energy level is an object of discussions. The aim of the study was to compare a truncated exponential biphasic waveform with monophasic damped sine waveform and antero-lateral with antero-posterior paddle positions for cardioversion of atrial fibrillation, to determine its impact on early reinitiation of atrial fibrillation. ⋯ For the cardioversion of atrial fibrillation, biphasic shock waveform has a higher success rate than monophasic shock waveform. We did not observe the influence of paddle positions on efficacy of cardioversion. Shock waveform and paddle position had no impact on ERAF. We recommend starting with biphasic energy of 150 J and monophasic of not less than 200 J for cardioversion of atrial fibrillation.