The University of Southampton
University of Southampton Institutional Repository

A comparison of rectilinear and truncated exponential biphasic waveforms in elective cardioversion of atrial fibrillation: a prospective randomized controlled trial

A comparison of rectilinear and truncated exponential biphasic waveforms in elective cardioversion of atrial fibrillation: a prospective randomized controlled trial
A comparison of rectilinear and truncated exponential biphasic waveforms in elective cardioversion of atrial fibrillation: a prospective randomized controlled trial
Background: several different biphasic waveforms are used clinically, but few studies have compared their efficacy. The two main waveforms are the biphasic rectilinear (BR) and biphasic truncated exponential (BTE) waveforms, both of which have important differences, particularly at the extremes of transthoracic impedance.

Objective: to compare the efficacy of two commonly used defibrillation waveforms in the elective cardioversion of atrial fibrillation.

Methods: in a prospective randomized controlled study, sequential adult patients undergoing elective cardioversion for AF were recruited. Patients were randomized to receive synchronized defibrillation using either a BR or BTE waveform, both using a 50 J, 100 J, 150 J, 200 J, 200 J selected energy escalating protocol. Failure to cardiovert after the fifth shock was classed as failed defibrillation. The power of this study was 80% with 5% significance level to detect a difference of 20% or greater between groups. Survival analysis was used to compare the total energy delivered to achieve successful cardioversion between groups.

Results: a total of 202 patients were recruited, of which data are complete for 199 (100 BR; 99 BTE). Median number of shocks to achieve cardioversion was 2 for the BR waveform and 3 for the BTE waveform (P = 0.059). In the BR waveform group, 95/100 (95.0%) achieved sinus rhythm. In the BTE waveform group, 90/99 (90.9%) achieved sinus rhythm and this group required on average 117.1 J more energy to achieve the outcome compared to the BR waveform group (P = 0.838).

Conclusions: BR and BTE waveforms show similar high efficacy in the elective cardioversion of atrial fibrillation
0300-9572
286-291
Deakin, C.D.
83906241-b698-496f-9853-41333a19ac1d
Connelly, S.
66a46a48-f8a8-44df-8c2d-a0c7be626542
Wharton, R.
e3f07c04-4465-4588-8887-2327f3f92045
Yuen, H.M.
b1df4c57-0c2a-44ac-ab40-22b88e8effe8
Deakin, C.D.
83906241-b698-496f-9853-41333a19ac1d
Connelly, S.
66a46a48-f8a8-44df-8c2d-a0c7be626542
Wharton, R.
e3f07c04-4465-4588-8887-2327f3f92045
Yuen, H.M.
b1df4c57-0c2a-44ac-ab40-22b88e8effe8

Deakin, C.D., Connelly, S., Wharton, R. and Yuen, H.M. (2013) A comparison of rectilinear and truncated exponential biphasic waveforms in elective cardioversion of atrial fibrillation: a prospective randomized controlled trial. Resuscitation, 84 (3), 286-291. (doi:10.1016/j.resuscitation.2012.07.010). (PMID:22842285)

Record type: Article

Abstract

Background: several different biphasic waveforms are used clinically, but few studies have compared their efficacy. The two main waveforms are the biphasic rectilinear (BR) and biphasic truncated exponential (BTE) waveforms, both of which have important differences, particularly at the extremes of transthoracic impedance.

Objective: to compare the efficacy of two commonly used defibrillation waveforms in the elective cardioversion of atrial fibrillation.

Methods: in a prospective randomized controlled study, sequential adult patients undergoing elective cardioversion for AF were recruited. Patients were randomized to receive synchronized defibrillation using either a BR or BTE waveform, both using a 50 J, 100 J, 150 J, 200 J, 200 J selected energy escalating protocol. Failure to cardiovert after the fifth shock was classed as failed defibrillation. The power of this study was 80% with 5% significance level to detect a difference of 20% or greater between groups. Survival analysis was used to compare the total energy delivered to achieve successful cardioversion between groups.

Results: a total of 202 patients were recruited, of which data are complete for 199 (100 BR; 99 BTE). Median number of shocks to achieve cardioversion was 2 for the BR waveform and 3 for the BTE waveform (P = 0.059). In the BR waveform group, 95/100 (95.0%) achieved sinus rhythm. In the BTE waveform group, 90/99 (90.9%) achieved sinus rhythm and this group required on average 117.1 J more energy to achieve the outcome compared to the BR waveform group (P = 0.838).

Conclusions: BR and BTE waveforms show similar high efficacy in the elective cardioversion of atrial fibrillation

Full text not available from this repository.

More information

Published date: March 2013
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 366161
URI: https://eprints.soton.ac.uk/id/eprint/366161
ISSN: 0300-9572
PURE UUID: e454c29f-528b-4930-a03e-7be0bb1bb3b0

Catalogue record

Date deposited: 23 Jun 2014 12:06
Last modified: 16 Jul 2019 21:02

Export record

Altmetrics

Contributors

Author: C.D. Deakin
Author: S. Connelly
Author: R. Wharton
Author: H.M. Yuen

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×