Dual Versus Single Shock for Cardioversion of Atrial Fibrillation
Atrial Fibrillation
About this trial
This is an interventional treatment trial for Atrial Fibrillation focused on measuring Cardioversion
Eligibility Criteria
Inclusion Criteria:
Outpatient or inpatients with atrial fibrillation sent for elective direct current cardioversion (DCCV) with at least 1 of the following risk factors will be included:
- BMI >30
- History of Chronic Obstructive Pulmonary Disease/emphysema/asthma
- Significant Valvular heart disease (at least moderate regurgitation/stenosis)
- History of Heart Failure with preserved Ejection Fraction/Heart Failure with reduced Ejection Fraction
- Cardiomyopathy with ejection fraction <40%
- Left atrium anterior-posterio (AP) dimension >4.5cm
- Presence of Left ventricular hypertrophy (≥1.1cm septal/posterior wall M-mode) on transthoracic echocardiogram
- History of sleep apnea
Exclusion Criteria:
- Consent not obtained
- <18 y.o.
- >80 y.o.
- Not adequately anti-coagulated
- Patient hemodynamically unstable and DCCV required as an emergent procedure
- Prisoners or pregnant patients
Sites / Locations
- University of Oklahoma Health Science Center
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Single Shock Group
Double Shock Group
Patients randomized to single shock will then be treated initially with a 200 Joule shock through the antero-posterior pads only.
Patients randomized to the dual shock group will have two near-simultaneous 200-Joule shocks delivered through the two sets of pads (antero-posterior position and right infraclavicular-axillary position). The first of these shocks will be synchronized.