Zhang Baowei, Li Xiaoli, Shen Dongli, Zhen Ya, Tao Aibin, Zhang Guohui
Department of cardiology, The Affiliated People's hospital of Jiangsu university, 8 Dianli road, Zhenjiang, Jiangsu 212002, China.
Department of cardiology, The Affiliated People's hospital of Jiangsu university, 8 Dianli road, Zhenjiang, Jiangsu 212002, China.
Arch Cardiovasc Dis. 2014 May;107(5):280-90. doi: 10.1016/j.acvd.2014.04.002. Epub 2014 May 20.
Several clinical trials have shown inconsistent results regarding the effect of electrode positions on the success of electrical cardioversion.
The aim of this meta-analysis was to investigate the effect of the anterior-posterior electrode position on the success of electrical cardioversion in patients undergoing external electrical cardioversion for atrial fibrillation.
Pubmed, EMBASE, the Cochrane Library and the Chinese National Knowledge Infrastructure were searched for randomized controlled trials. The effect of the anterior-posterior electrode position on cardioversion success is presented as a risk ratio with 95% confidence interval.
Ten trials with 1281 patients were included in the analysis. The anterior-posterior electrode position had no advantages in terms of success of electrical cardioversion for atrial fibrillation compared with the anterior-lateral electrode position (risk ratio 1.02, 95% confidence interval 0.96-1.09; P=0.50). Subgroup analysis showed that patients with a left atrium diameter≤45 mm and lone atrial fibrillation might derive benefits from the anterior-posterior electrode position in terms of success of cardioversion. No evidence of publication bias was detected.
The present analysis suggests that only patients with a left atrium diameter≤45 mm and lone atrial fibrillation might derive benefits from the anterior-posterior electrode position compared with the anterior-lateral electrode position during external electrical cardioversion for atrial fibrillation. However, there was insufficient evidence to support any advantages for the anterior-posterior electrode position in other situations.
多项临床试验表明，电极位置对电复律成功与否的影响结果并不一致。
本荟萃分析旨在研究在接受体外电复律治疗心房颤动的患者中，前后位电极位置对电复律成功的影响。
检索了PubMed、EMBASE、Cochrane图书馆和中国知网中的随机对照试验。前后位电极位置对复律成功的影响以风险比及95%置信区间表示。
分析纳入了10项试验，共1281例患者。与前外侧电极位置相比，前后位电极位置在心房颤动电复律成功方面并无优势（风险比1.02，95%置信区间0.96 - 1.09；P = 0.50）。亚组分析表明，左心房直径≤45 mm的患者及孤立性心房颤动患者在复律成功方面可能从前位-后位电极位置中获益。未检测到发表偏倚的证据。
目前的分析表明，在对心房颤动进行体外电复律时，与前外侧电极位置相比，仅左心房直径≤45 mm的患者及孤立性心房颤动患者可能从前位-后位电极位置中获益。然而，没有足够的证据支持前后位电极位置在其他情况下具有任何优势。
