Anteriolateral versus anterior-posterior electrodes in external cardioversion of atrial fibrillation: A systematic review and meta-analysis of clinical trials

Karam R. Motawea, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Mostafa Reda Mostafa, Rochester Regional HealthFollow
Merna Aboelenein, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Mohamed Magdi, Rochester Regional HealthFollow
Hager Fathy, Faculty of Medicine, Minia University, Minya, Egypt.
Sarya Swed, Faculty of Medicine, Aleppo University, Aleppo, Syria.
Mohamed M. Belal, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Dina M. Awad, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Rowan H. Elhalag, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Nesreen E. Talat, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Samah S. Rozan, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Abdulqadir J. Nashwan, Nursing Department, Hamad Medical Corporation, Doha, Qatar.
Naim Battikh, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois, USA.
Bisher Sawaf, Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Mhd K. Albuni, Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Elias Battikh, Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Gihan M. Mohamed, Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Amr Farwati, Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Hani Aiash, Cardiovascular Perfusion Department, Upstate Medical University, Syracuse, New York, USA.

Department

Medicine

Document Type

Article

Publication Title

Clinical Cardiology

Abstract

The efficacy of anteriolateral versus anterior-posterior electrode positions in the success of atrial fibrillation's (AF) electrical cardioversion is unclear. Our aim is to perform a meta-analysis to compare the success rate of both electrode positions. PUBMED, WOS, OVID, and SCOPUS were searched. Inclusion criteria were clinical trials that compared anterior-lateral with anterior-posterior electrodes in external cardioversion of AF. After the full-text screening, 11 trials were included in the analysis. The total number of patients included in the study is 1845. The pooled analysis showed a statistically significant association between anterior-lateral electrode and increased cardioversion rate of AF (odds ratio [OR] = 1.40, 95% confidence interval [CI] = 1.02-1.92, p = .04). Subgroup analysis revealed a statistically significant association between the anterior-lateral electrode and increased cardioversion rate of AF in subgroups of less than five shocks, patients with 60 years old or more and patients with left atrial (LA) diameter > 45 mm (OR = 1.72, 95% CI = 1.17-2.54, p = .006), (OR = 1.73, 95% CI = 1.18-2.54, p = .005), and (OR = 1.86, 95% CI = 1.04-3.34, p = .04), respectively. Anteriolateral electrode is more effective than anterior-posterior electrode in external cardioversion of AF, particularly in patients who have received less than 5 shocks, are 60 years old or older and have a LA diameter greater than 45 mm.

First Page

359

Last Page

375

DOI

10.1002/clc.23987

Volume

46

Issue

4

Publication Date

4-1-2023

PubMed ID

36756856

Link to Full Text

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