Active Compression During External Cardioversion of Atrial Fibrillation: A Meta-Analysis of Randomized Controlled Trials

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology Pub Date : 2025-04-01 DOI:10.1111/anec.70074

Hosam I. Taha, Abubakar Nazir, Ahmed A. Ibrahim, Mohamed S. Elgendy, Abdalhakim Shubietah, Hazem Reyad Mansour, Sherif Sary, Moataz Maged, Mustafa Turkmani, Mohamed Abuelazm

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引用次数: 0

Abstract

Objectives

Direct current cardioversion (DCCV) is commonly used for atrial fibrillation, but there is uncertainty about whether active chest compression improves its effectiveness. This meta-analysis evaluates the impact of active compression on cardioversion outcomes.

Methods

A systematic review and meta-analysis synthesizing evidence from randomized controlled trials (RCTs) retrieved from PubMed, Scopus, WOS, Embase, and Cochrane Library till September 2024. Statistical analysis was performed using R software (version 4.3.1), applying risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, with 95% confidence intervals (CI). PROSPERO ID: CRD42024595499.

Results

Four RCTs with 737 patients were included. When compared to the no-compression approach, active compression during DCCV was not associated with any significant difference in cardioversion success (RR: 1.10; 95% CI [0.96, 1.25], p = 0.16), first shock success (RR: 1.62; 95% CI [0.94, 2.81], p = 0.08), number of shocks (MD: -0.32; 95% CI [−1.01, 0.36], p = 0.36), or crossover success (MD: 0.76; 95% CI [0.33, 1.77], p = 0.52). However, active compression was associated with a reduced successful shock energy (MD: -23.97 J; 95% CI [−26.84, −21.10], p < 0.01).

Conclusion

Active compression during DCCV does not significantly improve cardioversion success but may reduce the energy required for successful cardioversion, suggesting potential safety benefits. However, further studies are needed to determine its clinical relevance.

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.