Anterior-lateral positioning of electrodes better for biphasic cardioversion of AF

Results:

Researchers randomized 468 patients. The primary outcome occurred in 126 patients (54%) assigned to the anterior-lateral electrodeposition and in 77 patients (33%) assigned to the anterior-posterior electrodeposition (risk difference, 22 percentage points [95% CI, 13-30]; P<0.001). The number of patients in sinus rhythm after the final cardioversion shock was 216 (93%) assigned to anterior-lateral electrode positioning and 200 (85%) assigned to anterior-posterior electrode positioning (risk difference, 7 percentage points [95% CI, 2-12]). There were no significant differences between groups in any safety outcomes.

Thus, anterior-lateral electrode positioning was more effective than anterior-posterior electrode positioning for biphasic cardioversion of atrial fibrillation. There were no significant differences in any safety outcome.

Reference:

Anterior-Lateral Versus Anterior-Posterior Electrode Position for Cardioverting Atrial Fibrillation by Anders Sjørslev Schmidt et al. published in the Circulation.

Keywords:

atrial fibrillation, electric countershock, electrodes, Anterior-lateral positioning, an anterior-posterior electrode for biphasic cardioversion, electrode positioning for atrial fibrillation, biphasic cardioversion of atrial fibrillation, Circulation, Anders Sjørslev Schmidt, Kasper Glerup Lauridsen, Dorthe Svenstrup Møller, Per Dahl Christensen, Karen Kaae Dodt, Hans Rickers, Bo Løfgren, Andi Eie Albertsen