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Cardioversion Efficacy Using Pulsed Biphasic or Biphasic Truncated Exponential Waveforms: A Randomized Clinical

Anders S Schmidt^1,2,3, Kasper G Lauridsen^1,2,3, Kasper Adelborg^2,4,5

¹Clinical Research Unit, Regional Hospital of Randers, Randers NE, Denmark.

Journal of the American Heart Association

|March 10, 2017

Summary

This summary is machine-generated.

Biphasic truncated exponential (BTE) waveform cardioversion proved more effective than pulsed biphasic (PB) waveform for atrial fibrillation and flutter. Both defibrillation methods demonstrated similar safety profiles regarding myocardial injury.

Keywords:

atrial fibrillation biphasic waveforms cardioversion

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Published on: December 11, 2017

Area of Science:

Cardiology
Electrophysiology
Medical Devices

Background:

Current defibrillators for cardiac arrhythmias vary.
The efficacy of novel pulsed biphasic (PB) waveforms requires comparison with existing biphasic waveforms.
Atrial fibrillation and flutter are common cardiac arrhythmias requiring cardioversion.

Purpose of the Study:

To compare the efficacy and safety of pulsed biphasic (PB) shocks versus biphasic truncated exponential (BTE) shocks for cardioversion.
To evaluate success rates and myocardial injury markers between PB and BTE waveforms.

Main Methods:

Prospective, randomized study of patients undergoing elective direct current cardioversion.
Patients randomized to receive either PB or BTE shocks with escalating energy levels.
Successful cardioversion defined as achieving sinus rhythm 4 hours post-procedure; safety assessed by troponin I levels.

Main Results:

Biphasic truncated exponential (BTE) waveform cardioversion achieved a significantly higher success rate (86%) compared to pulsed biphasic (PB) waveform (62%) (P=0.002).
No significant difference in safety was observed between PB and BTE waveforms, as indicated by troponin I levels (P=0.15).
The study was prematurely terminated due to an adverse event.

Conclusions:

Biphasic truncated exponential (BTE) waveform is more effective for cardioversion of atrial fibrillation and flutter than pulsed biphasic (PB) waveform.
Both PB and BTE waveforms exhibit comparable safety profiles concerning myocardial injury.