Estudio aleatorizado sobre la posición de electrodos en la cardioversión eléctrica electiva de la fibrilación auricular

Muñoz-Martínez, T.; Castañeda-Saiz, A.; Vinuesa-Lozano, C.; Aretxabala-Kortajarena, N.; Dudagoitia-Otaolea, Juan Luis; Iribarren-Diarasarri, S.; Ruiz-Zorrilla, José María; Hernández-López, M.; Castillo-Arenal, Carlos

doi:10.1016/j.medin.2009.10.004

Cited by 7 publications

(8 citation statements)

References 15 publications

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“…8 In addition, anterior-lateral and anterior-posterior electrode positions have been compared in 6 randomized studies using biphasic shocks. 4,[10][11][12][13]15 As for the studies on monophasic cardioversion, these studies showed varying results, likely reflecting risk of bias or inadequate sample sizes. Two small studies found anterior-lateral electrode positioning more effective than anterior-posterior electrode positioning, 13,15 whereas other studies found no difference between electrode positions.…”

Section: Discussionmentioning

confidence: 99%

“…4,[10][11][12][13]15 As for the studies on monophasic cardioversion, these studies showed varying results, likely reflecting risk of bias or inadequate sample sizes. Two small studies found anterior-lateral electrode positioning more effective than anterior-posterior electrode positioning, 13,15 whereas other studies found no difference between electrode positions. 4,[10][11][12] Overall, these findings for biphasic cardioversion tended toward anterior-lateral position being superior to anterior-posterior electrode position, thus challenging the previous believe of anterior-posterior electrode position being superior.…”

Section: Discussionmentioning

confidence: 99%

“…Several smaller randomized studies have reported conflicting results. [4][5][6][7][8][9][10][11][12][13][14][15] Two studies using monophasic shocks found anterior-posterior electrode positioning to be more effective than anterior-lateral electrode positioning. 5,8 Accordingly, the anterior-posterior electrode position is widely used and suggested as optimal for cardioverting AF.…”

mentioning

confidence: 99%

“…[18][19][20][21] Therefore, findings from studies using monophasic shocks may not translate to current clinical practice that uses contemporary biphasic shocks. Two smaller studies used biphasic shocks and suggested that an anterior-lateral electrode position is more effective than an anterior-posterior electrode position, 13,15 whereas other studies have found no differences between the 2 positions. 4,[10][11][12] Consequently, there is considerable controversy about the optimal electrode position for biphasic cardioversion.…”

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confidence: 99%

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Anterior–Lateral Versus Anterior–Posterior Electrode Position for Cardioverting Atrial Fibrillation

et al. 2021

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Background: Smaller randomized studies have reported conflicting results regarding the optimal electrode position for cardioverting atrial fibrillation. However, anterior-posterior electrode position is widely used as a standard and believed to be superior to anterior-lateral electrode position. Therefore, we aimed to compare anterior-lateral and anterior-posterior electrode position for cardioverting atrial fibrillation in a multicenter randomized trial. Methods: In this multicenter, investigator-initiated, open-label trial, we randomly assigned patients with atrial fibrillation scheduled for elective cardioversion to anterior-lateral or anterior-posterior electrode position. The primary outcome was the proportion of patients in sinus rhythm after the first shock. The secondary outcome was the proportion of patients in sinus rhythm after up to four shocks escalating to maximum energy. Safety outcomes were any cases of arrhythmia during or after cardioversion, skin redness, and patient-reported peri-procedural pain. Results: We randomized 468 patients. The primary outcome occurred in 126 patients (54%) assigned to anterior-lateral electrode position and in 77 patients (33%) assigned to anterior-posterior electrode position, a risk difference of 22 percentage-points, 95%-confidence interval: 13-30, P<0.001. The number of patients in sinus rhythm after the final cardioversion shock was 216 patients (93%) assigned to anterior−lateral electrode position and 200 patients (85%) assigned to anterior-posterior electrode position, a risk difference of 7 percentage−points, 95%−confidence interval: 2−12. There were no significant differences between groups in any safety outcomes. Conclusions: Anterior-lateral electrode position was more effective than anterior-posterior electrode position for biphasic cardioversion of atrial fibrillation. There were no significant differences in any safety outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Anterior–Lateral Versus Anterior–Posterior Electrode Position for Cardioverting Atrial Fibrillation

et al. 2021

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“…Specifically, three of these studies were either not in English or inaccessible in full text, preventing their inclusion. 3,4 The fourth study focused primarily on a subgroup analysis of patients with obesity, which did not align with our broader inclusion criteria encompassing all patient demographics, not limited to specific conditions like obesity. 5 Concerning the inclusion of a prospective study, it appears there was a misunderstanding about the nature of the study we included.…”

Section: Dear Editormentioning

confidence: 99%

Response to Nguyen et al.'s letter regarding “Anteriolateral versus anterior–posterior electrodes in external cardioversion of atrial fibrillation: A systematic review and meta‐analysis of clinical trials”

Motawea,

Nashwan

2024

Clinical Cardiology

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Letter regarding “Anteriolateral versus anterior–posterior electrodes in external cardioversion of atrial fibrillation: A systematic review and meta‐analysis of clinical trials”

Nguyen,

Belley‐Côté,

McIntyre

2024

Clinical Cardiology

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Estudio aleatorizado sobre la posición de electrodos en la cardioversión eléctrica electiva de la fibrilación auricular

Cited by 7 publications

References 15 publications

Anterior–Lateral Versus Anterior–Posterior Electrode Position for Cardioverting Atrial Fibrillation

Anterior–Lateral Versus Anterior–Posterior Electrode Position for Cardioverting Atrial Fibrillation

Response to Nguyen et al.'s letter regarding “Anteriolateral versus anterior–posterior electrodes in external cardioversion of atrial fibrillation: A systematic review and meta‐analysis of clinical trials”

Letter regarding “Anteriolateral versus anterior–posterior electrodes in external cardioversion of atrial fibrillation: A systematic review and meta‐analysis of clinical trials”

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