Baowei Zhang1, Xiaoli Li1, Dongli Shen1, Ya Zhen1, Aibin Tao1, Guohui Zhang2. 1. Department of cardiology, The Affiliated People's hospital of Jiangsu university, 8 Dianli road, Zhenjiang, Jiangsu 212002, China. 2. Department of cardiology, The Affiliated People's hospital of Jiangsu university, 8 Dianli road, Zhenjiang, Jiangsu 212002, China. Electronic address: guohuizhang2013@126.com.
Abstract
BACKGROUND: Several clinical trials have shown inconsistent results regarding the effect of electrode positions on the success of electrical cardioversion. AIMS: The aim of this meta-analysis was to investigate the effect of the anterior-posterior electrode position on the success of electrical cardioversion in patients undergoing external electrical cardioversion for atrial fibrillation. METHODS: Pubmed, EMBASE, the Cochrane Library and the Chinese National Knowledge Infrastructure were searched for randomized controlled trials. The effect of the anterior-posterior electrode position on cardioversion success is presented as a risk ratio with 95% confidence interval. RESULTS: Ten trials with 1281 patients were included in the analysis. The anterior-posterior electrode position had no advantages in terms of success of electrical cardioversion for atrial fibrillation compared with the anterior-lateral electrode position (risk ratio 1.02, 95% confidence interval 0.96-1.09; P=0.50). Subgroup analysis showed that patients with a left atrium diameter≤45 mm and lone atrial fibrillation might derive benefits from the anterior-posterior electrode position in terms of success of cardioversion. No evidence of publication bias was detected. CONCLUSIONS: The present analysis suggests that only patients with a left atrium diameter≤45 mm and lone atrial fibrillation might derive benefits from the anterior-posterior electrode position compared with the anterior-lateral electrode position during external electrical cardioversion for atrial fibrillation. However, there was insufficient evidence to support any advantages for the anterior-posterior electrode position in other situations.
BACKGROUND: Several clinical trials have shown inconsistent results regarding the effect of electrode positions on the success of electrical cardioversion. AIMS: The aim of this meta-analysis was to investigate the effect of the anterior-posterior electrode position on the success of electrical cardioversion in patients undergoing external electrical cardioversion for atrial fibrillation. METHODS: Pubmed, EMBASE, the Cochrane Library and the Chinese National Knowledge Infrastructure were searched for randomized controlled trials. The effect of the anterior-posterior electrode position on cardioversion success is presented as a risk ratio with 95% confidence interval. RESULTS: Ten trials with 1281 patients were included in the analysis. The anterior-posterior electrode position had no advantages in terms of success of electrical cardioversion for atrial fibrillation compared with the anterior-lateral electrode position (risk ratio 1.02, 95% confidence interval 0.96-1.09; P=0.50). Subgroup analysis showed that patients with a left atrium diameter≤45 mm and lone atrial fibrillation might derive benefits from the anterior-posterior electrode position in terms of success of cardioversion. No evidence of publication bias was detected. CONCLUSIONS: The present analysis suggests that only patients with a left atrium diameter≤45 mm and lone atrial fibrillation might derive benefits from the anterior-posterior electrode position compared with the anterior-lateral electrode position during external electrical cardioversion for atrial fibrillation. However, there was insufficient evidence to support any advantages for the anterior-posterior electrode position in other situations.
Authors: Jasmeet Soar; Bernd W Böttiger; Pierre Carli; Keith Couper; Charles D Deakin; Therese Djärv; Carsten Lott; Theresa Olasveengen; Peter Paal; Tommaso Pellis; Gavin D Perkins; Claudio Sandroni; Jerry P Nolan Journal: Notf Rett Med Date: 2021-06-08 Impact factor: 0.826