Arrhythmias & electrophysiologyRandomised controlled trial
Maximum-fixed energy shocks for cardioverting atrial fibrillation
- Randomised controlled trial
- single-centre
- single-blinded
Authors' conclusion
Maximum-fixed energy shocks were more effective compared with low-escalating energy shocks for cardioverting atrial fibrillation. We found no difference in any safety endpoint.
Study context
- Population
- Elective AF patients undergoing direct-current cardioversion
- Participants
- 276 patients
- Comparison
- Maximum-fixed vs low-escalating energy shocks for cardioversion of AF
- Maximum-fixed energyn = 129
- Low-escalating energyn = 147reference
- Primary endpoint
- Sinus rhythm
- Follow-up
- 1 min after cardioversion
Primary result
Sinus rhythm 1 min after cardioversion
Between-group difference
22 percentage points
95% CI 13–32
P < 0.001
Events by treatment group
Maximum-fixed energy vs Low-escalating energy
between-group difference 22 percentage points (95% CI 13–32); P < 0.001
As reported in the abstract
Further findings
| Outcome | Maximum-fixed energy | Low-escalating energy | between-group difference (percentage points) (95% CI) | |
|---|---|---|---|---|
| Sinus rhythm after first shock | 75% | 34% | 41 (30–51) | |
| −50050100Difference, percentage points (linear scale) |
Safety
Any arrhythmia, myocardial injury, skin burns, patient-reported pain · after cardioversion
- No significant difference between groups in any safety endpoint
Original publication
Maximum-fixed energy shocks for cardioverting atrial fibrillation. Eur Heart J. Published 31 August 2019. doi:10.1093/eurheartj/ehz585
Summarised from the published abstract; every number is checked against it