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MAX-SHOCK: A Pragmatic Randomized Controlled Trial Comparing Biphasic Defibrillators Used in Routine Cardioversion of

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Summary
This summary is machine-generated.

Electrical cardioversion for atrial fibrillation (AF) often fails. This study compares two defibrillators to find the best device for successful AF rhythm control.

Keywords:
atrial fibrillationcardioversiondefibrillator

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Area of Science:

  • Cardiology
  • Medical Devices

Background:

  • Atrial fibrillation (AF) management frequently involves electrical cardioversion, yet failure rates remain significant.
  • Current clinical practices for electrical cardioversion vary, particularly concerning device selection and energy delivery.
  • Different biphasic defibrillators possess unique waveform characteristics and adaptive algorithms that may impact cardioversion success.

Purpose of the Study:

  • To compare the real-world performance of two commonly used external defibrillators in achieving successful electrical cardioversion for persistent atrial fibrillation.
  • To evaluate whether a higher energy-capable defibrillator (360 J) leads to a greater success rate compared to a lower energy-capable device (200 J) within a standardized protocol.

Main Methods:

  • A single-center, prospective, randomized, single-blinded controlled study involving 356 adult patients with persistent AF.
  • Comparison of the Physio-Control LIFEPAK 20 (up to 360 J) and the ZOLL Medical R-Series (up to 200 J) defibrillators.
  • Primary outcome: successful cardioversion defined as restoration and maintenance of sinus rhythm.

Main Results:

  • This section is pending study completion as the abstract describes the trial design and hypothesis, not the outcomes.
  • The study hypothesizes that the 360-J-capable defibrillator will demonstrate a higher rate of successful cardioversion.

Conclusions:

  • This trial is the first randomized comparison of different defibrillator systems for AF cardioversion.
  • Findings will inform clinical decisions regarding defibrillator selection and optimize electrical cardioversion protocols.