-
Je něco špatně v tomto záznamu ?
Optimizing Energy Delivery in Cardioversion: A Randomized PROTOCOLENERGYTrial of 2 Different Algorithms in Patients With Atrial Fibrillation
M. Roman, R. Lucjan, J. Otakar, S. Radim, C. Jan, N. Radek, H. Miroslav, S. Libor, JG. Bogna, H. Jan, F. Martin
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články, randomizované kontrolované studie, srovnávací studie
- MeSH
- algoritmy * MeSH
- elektrická defibrilace * metody MeSH
- fibrilace síní * terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
BACKGROUND: The optimal energy protocol for direct current cardioversion of atrial fibrillation remains uncertain. The Rational vs Maximum Fixed Energy (PROTOCOLENERGY) randomized trial compared a stepwise escalating energy algorithm (RaA, 150 J, 360 J, and 360 J) with a maximum fixed energy algorithm (MfA, 3 x 360 J). METHODS: In a 1:1 randomized trial, 300 patients with atrial fibrillation received biphasic discharges via hand-held paddles in the anterolateral position. Primary endpoints were sinus rhythm at 1 minute and neurologic complications at 2 hours; secondary endpoints included sinus rhythm at 2 hours, skin changes and chest discomfort at 24 hours. RESULTS: Sinus rhythm at 1 minute was achieved in 92.7% of RaA and 94.0% of MfA patients (P = 0.643) and maintained at 2 hours in 91.3% of both groups. There were no neurologic complications. The protocols differed significantly after the first shock (72.7% in RaA vs 83.3% in MfA; P = 0.026) but equalized after subsequent maximum energy shocks. Fewer RaA patients experienced skin redness compared with MfA patients (19.3% vs 36.0%, P = 0.001), which was attributed to the lower initial 150-J shock and total energy delivered (r = 0.243, P < 0.0001). Chest discomfort at 24 hours was not different between groups (P = 0.378). In multivariate analysis, lower body mass index (P < 0.001, cutoff 29 to 34 kg/m2) was associated with cardioversion success after the initial 150-J shock. CONCLUSIONS: Both protocols showed similar high cumulative efficacy, but RaA with the initial 150-J shock proved to be beneficial in patients with body mass index less than 29 to 34 kg/m2 because of fewer skin complications. CLINICAL TRIAL REGISTRATION NO: NCT05148923.
3rd Faculty of Medicine Charles University Praha Czechia
Centre of Cardiovascular Care Neuron Medical Brno Czechia
Department of Cardiology Nemocnice Agel Trinec Podlesi Trinec Czechia
Department of Cybernetics and Biomedical Engineering Ostrava Czechia
Citace poskytuje Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc25003736
- 003
- CZ-PrNML
- 005
- 20250206104646.0
- 007
- ta
- 008
- 250121s2024 enk f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1016/j.cjca.2024.06.003 $2 doi
- 035 __
- $a (PubMed)38857688
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a enk
- 100 1_
- $a Roman, Miklik $u Department of Cardiology, Nemocnice Agel Trinec-Podlesi, Trinec, Czechia
- 245 10
- $a Optimizing Energy Delivery in Cardioversion: A Randomized PROTOCOLENERGYTrial of 2 Different Algorithms in Patients With Atrial Fibrillation / $c M. Roman, R. Lucjan, J. Otakar, S. Radim, C. Jan, N. Radek, H. Miroslav, S. Libor, JG. Bogna, H. Jan, F. Martin
- 520 9_
- $a BACKGROUND: The optimal energy protocol for direct current cardioversion of atrial fibrillation remains uncertain. The Rational vs Maximum Fixed Energy (PROTOCOLENERGY) randomized trial compared a stepwise escalating energy algorithm (RaA, 150 J, 360 J, and 360 J) with a maximum fixed energy algorithm (MfA, 3 x 360 J). METHODS: In a 1:1 randomized trial, 300 patients with atrial fibrillation received biphasic discharges via hand-held paddles in the anterolateral position. Primary endpoints were sinus rhythm at 1 minute and neurologic complications at 2 hours; secondary endpoints included sinus rhythm at 2 hours, skin changes and chest discomfort at 24 hours. RESULTS: Sinus rhythm at 1 minute was achieved in 92.7% of RaA and 94.0% of MfA patients (P = 0.643) and maintained at 2 hours in 91.3% of both groups. There were no neurologic complications. The protocols differed significantly after the first shock (72.7% in RaA vs 83.3% in MfA; P = 0.026) but equalized after subsequent maximum energy shocks. Fewer RaA patients experienced skin redness compared with MfA patients (19.3% vs 36.0%, P = 0.001), which was attributed to the lower initial 150-J shock and total energy delivered (r = 0.243, P < 0.0001). Chest discomfort at 24 hours was not different between groups (P = 0.378). In multivariate analysis, lower body mass index (P < 0.001, cutoff 29 to 34 kg/m2) was associated with cardioversion success after the initial 150-J shock. CONCLUSIONS: Both protocols showed similar high cumulative efficacy, but RaA with the initial 150-J shock proved to be beneficial in patients with body mass index less than 29 to 34 kg/m2 because of fewer skin complications. CLINICAL TRIAL REGISTRATION NO: NCT05148923.
- 650 _2
- $a lidé $7 D006801
- 650 12
- $a fibrilace síní $x terapie $7 D001281
- 650 12
- $a elektrická defibrilace $x metody $7 D004554
- 650 _2
- $a ženské pohlaví $7 D005260
- 650 _2
- $a mužské pohlaví $7 D008297
- 650 12
- $a algoritmy $7 D000465
- 650 _2
- $a lidé středního věku $7 D008875
- 650 _2
- $a senioři $7 D000368
- 650 _2
- $a výsledek terapie $7 D016896
- 650 _2
- $a následné studie $7 D005500
- 655 _2
- $a časopisecké články $7 D016428
- 655 _2
- $a randomizované kontrolované studie $7 D016449
- 655 _2
- $a srovnávací studie $7 D003160
- 700 1_
- $a Lucjan, Rucki $u Department of Cardiology, Nemocnice Agel Trinec-Podlesi, Trinec, Czechia
- 700 1_
- $a Otakar, Jiravsky $u Department of Cardiology, Nemocnice Agel Trinec-Podlesi, Trinec, Czechia; Faculty of Medicine, Masaryk University, Brno, Czechia. Electronic address: otakar.jiravsky@npo.agel.cz
- 700 1_
- $a Radim, Spacek $u Department of Cardiology, Nemocnice Agel Trinec-Podlesi, Trinec, Czechia; Third Faculty of Medicine, Charles University, Praha, Czechia
- 700 1_
- $a Jan, Chovancik $u Department of Cardiology, Nemocnice Agel Trinec-Podlesi, Trinec, Czechia
- 700 1_
- $a Radek, Neuwirth $u Department of Cardiology, Nemocnice Agel Trinec-Podlesi, Trinec, Czechia; Faculty of Medicine, Masaryk University, Brno, Czechia
- 700 1_
- $a Miroslav, Hudec $u Department of Cardiology, Nemocnice Agel Trinec-Podlesi, Trinec, Czechia; Faculty of Medicine, Masaryk University, Brno, Czechia
- 700 1_
- $a Libor, Sknouril $u Department of Cardiology, Nemocnice Agel Trinec-Podlesi, Trinec, Czechia
- 700 1_
- $a Bogna, Jiravska Godula $u Department of Cardiology, Nemocnice Agel Trinec-Podlesi, Trinec, Czechia; Faculty of Medicine, Palacky University, Olomouc, Czechia
- 700 1_
- $a Jan, Hecko $u Department of Cardiology, Nemocnice Agel Trinec-Podlesi, Trinec, Czechia; Department of Cybernetics and Biomedical Engineering, Ostrava, Czechia
- 700 1_
- $a Martin, Fiala $u Faculty of Medicine, Masaryk University, Brno, Czechia; Centre of Cardiovascular Care, Neuron Medical, Brno, Czechia
- 773 0_
- $w MED00001009 $t Canadian journal of cardiology $x 1916-7075 $g Roč. 40, č. 11 (2024), s. 2130-2141
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/38857688 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y - $z 0
- 990 __
- $a 20250121 $b ABA008
- 991 __
- $a 20250206104642 $b ABA008
- 999 __
- $a ok $b bmc $g 2263484 $s 1239743
- BAS __
- $a 3
- BAS __
- $a PreBMC-MEDLINE
- BMC __
- $a 2024 $b 40 $c 11 $d 2130-2141 $e 20240608 $i 1916-7075 $m Canadian journal of cardiology $n Can J Cardiol $x MED00001009
- LZP __
- $a Pubmed-20250121
