External versus internal cardioversion for atrial fibrillation: a meta-analysis of randomized controlled trials

Background Patients with atrial fibrillation (AF) often require rhythm control strategy for amelioration of symptoms. It is unclear if there is any difference between external cardioversion (ECV) and internal cardioversion (ICV) for successful conversion of AF to normal sinus rhythm. Methods We perf...

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Bibliographic Details
Published in:Journal of interventional cardiac electrophysiology 2021-09, Vol.61 (3), p.445-451
Main Authors: Aggarwal, Gaurav, Anantha-Narayanan, Mahesh, Robles, Julian, Bandyopadhyay, Dhrubajyoti, Abed, Mary, Henry, Brandon Michael, Aggarwal, Saurabh, Alla, Venkata
Format: Article
Language:English
Subjects:
Cardiac arrhythmia
Cardiology
Cardioversion
Clinical trials
Fibrillation
Medicine
Medicine & Public Health
Meta-analysis
Rhythm
Subgroups
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Summary:Background Patients with atrial fibrillation (AF) often require rhythm control strategy for amelioration of symptoms. It is unclear if there is any difference between external cardioversion (ECV) and internal cardioversion (ICV) for successful conversion of AF to normal sinus rhythm. Methods We performed a meta-analysis of published randomized controlled trials (RCTs) evaluating success of cardioversion using ECV versus ICV. Results In the pooled analysis of 5 RCTS, there was no difference in success of cardioversion using ECV versus ICV (OR 1.69, 95% CI 0.24–11.83, p  = 0.6). In the subgroup analysis, there was no difference between ECV and direct electrode ICV (OR 0.41, 95% CI 0.09–1.83, p  = 0.24). However, ECV was significantly better compared with ICV using ICD (OR 11.97, 95% CI 1.87–76.73, p  = 0.009). Conclusions There was no difference between ECV versus ICV in effectiveness for termination of AF. Larger well-designed randomized controlled trials are needed to confirm our findings.
ISSN:1383-875X
1572-8595
DOI:10.1007/s10840-020-00836-5