Atrial fibrillation is the most common heart rhythm disorder, and the incidence is rapidly increasing. Cardioversion using an electrical shock (DC-cardioversion) is an important treatment to reduce symptoms and improve patient's quality-of-life. The treatment is performed by applying gel electrodes to the chest. Cardioversion is not always successful, and it is unknown which electrode-position provides the optimal efficacy. This study aims to compare two electrode positions, which are in clinical use: Anterior-posterior (left front and left back) versus anterior-lateral (right front and left side of the chest).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
468
Escalating energy shocks (100 J, 150 J, 200 J, 360 J) using anterior-posterior electrode position
Escalating energy shocks (100 J, 150 J, 200 J, 360 J) using anterior-lateral electrode position
Horsens Regional Hospital
Horsens, Denmark
Randers Regional Hospital
Randers, Denmark
Viborg Regional Hospital
Viborg, Denmark
Efficacy: First shock success
The primary endpoint will be first shock efficacy, i.e. the proportion of patients in sinus rhythm for at least one minute immediately after an initial shock of 100 J.
Time frame: Immediately after first cardioversion attempt.
Efficacy: Successful cardioversion
The secondary efficacy endpoint will be cardioversion success, i.e. the proportion of patients in sinus rhythm for at least one minute after end of protocol.
Time frame: One minute after cardioversion
Safety: Number of participants with arrhythmic events during and after cardioversion
Secondary safety endpoints will be arrhythmia during and after cardioversion (asystole, transient bradycardia, ventricular arrhythmia, atrioventricular block, recurrence of atrial fibrillation)
Time frame: Within 2 hours after cardioversion (until discharge)
Safety: Number of participants with skin-discomfort, skin burns or itching
Patient-reported peri-procedural discomfort when asked at discharge.
Time frame: Two hours after cardioversion (at discharge)
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