| Autor: |
Glover, B. M., Walsh, S. J., Mccann, C. J., Moore, M. J., Manoharan, G., Dalzell, G. W. N., McAllister, A., McClements, B., McEneaney, D. J., Trouton, T. G., Mathew, T. P., Adgey, A. A. J. |
| Předmět: |
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| Zdroj: |
Heart; Jul2008, Vol. 94 Issue 7, p884-887, 4p, 1 Diagram, 1 Chart |
| Abstrakt: |
Aims: To compare the efficacy and safety of an escalating energy protocol with a non-escalating energy protocol using an impedance compensated biphasic defibrillator for direct current cardioversion of atrial fibrillation (AF). Methods and results: This prospective multicentre randomised trial enrolled 380 patients (248 male, mean (SD) age 67(10) years) with AF. Patients were randomised to either an escalating energy protocol (protocol A: 100 J, 150 J, 200 J, 200 J), or a non-escalating energy protocol (protocol B: 200 J, 200 J, 200 J). Cardioversion was performed using an impedance compensated biphasic waveform. First-shock success was significantly higher for those randomised to 200 J than 100 J (71% vs 48%; p<0.01) and for patients with a body mass index (BMI) >25 kg/m² (75% vs 44%; p = 0.01). In patients with a normal BMI there was no significant difference in first-shock success. There was also no significant difference between subsequent shocks or overall success. The use of a non-escalating protocol (protocol B) resulted in fewer shocks but with a higher cumulative energy. There was no difference in duration of procedure, amount of sedation administered or post- shock erythema between the groups. Conclusion: First-shock success was significantly higher, particularly in patients with a BMI >25 kg/m², when a non-escalating initial 200 J energy was selected. The overall success, duration of procedure and amount of sedation administered, however, did not differ significantly between the two protocols. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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