Monophasic and biphasic shock for transthoracic conversion of atrial fibrillation: Systematic review and network meta-analysis

Resuscitation
José Francisco Secorun InácioClarissa Garcia Rodrigues

Abstract

Conduct a systematic review of the literature to compare the efficacy of different biphasic and monophasic shock waveforms technologies for transthoracic cardioversion of Atrial Fibrillation (AF). We searched PubMed, EMBASE, The Cochrane Library, LILACS and ClinicalTrials.gov databases for randomized clinical trials comparing two or more defibrillation waveforms when performing elective transthoracic cardioversion of AF. The outcomes assessed were 1st shock success, overall success, cumulative energy and number of shocks to restore Normal Sinus Rhythm. Were included 23 trials involving 3046 patients, 5 biphasic and the monophasic waveform. Direct meta-analysis revealed that Biphasic waveforms have higher chance to achieve cardioversion in the 1st shock (OR: 3.2; 95% CI 2.2-4.7) and after a sequence of attempts (OR:2.4; 95% CI 1.5-3.9), requiring 296 less Joules (95% CI 356-237) and 0.74 less shocks (95%CI 1.03-0.44) when compared to Monophasic. Network meta-analysis showed no significant differences between the Biphasic technologies of PhysioControl ADAPTIV, Philips SMART and ZOLL Rectilinear, in any of the four outcomes. The evidences points to a Biphasic waveform superiority over Monophasic to perform AF cardioversion, suppor...Continue Reading

References

Sep 14, 1999·Journal of the American College of Cardiology·W TangJ Bisera
May 3, 2001·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·P RicardG Bardy
Aug 31, 2004·Journal of Cardiovascular Electrophysiology·Stephanos SiaplaourasJens Jung
Feb 3, 2005·Pacing and Clinical Electrophysiology : PACE·Dariusz Artur KosiorDaniel Rabczenko
Apr 27, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Faisal AlatawiPaul A Friedman
Feb 3, 2007·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Vitor S KawabataLuiz A Cesar

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Citations

Jan 15, 2021·European Heart Journal. Case Reports·Enrique Velázquez-RodríguezFrancisco Javier Rangel-Rojo

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