Atrial fibrillation: cardioversion: anteroposterior pads were not clearly better than anteroanterior pads

Clinical bottom line (level 1b-)

  1. Patients with atrial fibrillation who received cardioversion using anteroposterior pads compared with anteroanterior pads were not clearly more likely to have a successful cardioversion.
Mathew et al: Heart 1999; 81: 576-579
Expires November 2002

The study

Unblinded ?concealed randomised trial with intention-to-treat
Setting: university hospital, UK

90 patients (aged mean 66, 66% male) undergoing elective cardioversion for atrial fibrillation

Excluded if
  • permanent pacemaker in situ


    • Control Group: (n = 45, 45 analysed): anteroanterior pad position
    Experimental Group: (n = 45, 45 analysed): anteroposterior pad position

    100% followed for ?

    The evidence

    Outcome Time to outcome CEREERRRR
    (95% CI)    		ARR
    (95% CI)    		NNH
    (95% CI)
    successful cardioversion unknown 38
    (84.4%)    		 35
    (77.8%)    		 -8%
    (-25% to 13%)    		 -6.67%
    (-22.8% to 9.45%)    		 15
    (NNT = 11 to infinity;
    NNH = 4 to infinity)

    Comments

    1. The study is too small to show any difference between the two groups.

    Citation

    1. Mathew TP, Moore A, McIntyre M, et al: Randomised comparison of electrode positions for cardioversion of atrial fibrillation. Heart 1999; 81: 576-579
    Search Terms: ?
    Contributor: Chris Ball and Clare Wotton, November 1999
    Reviewer:

    Clinical Question.
    Patient atrial fibrillation
    Intervention or Exposure cardioversion with anteroposterior pads
    Comparison cardioversion with anteroanterior pads
    Outcome successful cardioversion