Heart : official journal of the British Cardiac Society
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of monophasic and biphasic shocks for transthoracic cardioversion of atrial fibrillation.
To compare the efficacy of cardioversion in patients with atrial fibrillation between monophasic damped sine waveform and rectilinear biphasic waveform shocks at a high initial energy level and with a conventional paddle position. ⋯ A protocol using monophasic waveform shocks in a 200-360 J sequence has the same efficacy (90%) as a protocol using rectilinear biphasic waveform shocks in a 120-200 J sequence. This equal efficacy is achieved with a significantly lower mean delivered energy level using the rectilinear biphasic shock waveform. The potential advantage of lower energy delivery for cardioversion of atrial fibrillation needs further study.