However, optimal selection algorithm and ideal duration of monitoring remain unclear. To determine the incidence and time-profile of PAF in patients with cryptogenic ischemic stroke studied with Reveal XT ILR, who were selected based on a high suspicion of cerebral embolism.
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We reviewed the information online each month and patients underwent clinical visits at 3rd and 6th month and then every six months. Mean age was 67 years, 54 women Occult PAF was detected in 34 patients CiteScore measures average citations received per document published. Read more. SRJ is a prestige metric based on the idea that not all citations are the same.
SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact. SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field. Home Articles in press Current Issue Archive. ISSN: The published literature is restricted to persistent atrial fibrillation and flutter, is of low methodologic quality, employs variability in pad placement, and uses energy levels lower than currently recommended. Not surprisingly, the accumulated evidence suggests that electrical pad placement is not a critically important factor in successful cardioversion in atrial fibrillation and flutter.
Importantly, anterolateral placement for the initial shock appears to be more effective when using the biphasic devices currently used in most North American EDs. The authors thank Drs. Stephanos Siaplaouras, Tim Risius, and Tomas Munoz for responding to our requests for additional information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors.
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Academic Emergency Medicine Volume 21, Issue 7. Progressive Clinical Practice Free Access. Brian H. This study was unfunded. The authors have no relevant financial information or potential conflicts of interest to disclose. Tools Request permission Export citation Add to favorites Track citation. Share Give access Share full text access. Share full text access.
Cardioversión eléctrica para la fibrilación auricular
Please review our Terms and Conditions of Use and check box below to share full-text version of article. Abstract en Objectives Electrical cardioversion is commonly used to treat patients with atrial fibrillation and atrial flutter to restore normal sinus rhythm. Results From citations, 13 studies were included; seven involved monophasic, five involved biphasic, and one analyzed both waveform devices. Methods We developed a study protocol a priori to define the objective, outline the search strategy, establish explicit selection criteria, determine the primary outcome, guide the data collection process, and define the analysis.
Data Extraction Two reviewers SWK, TYA independently extracted data onto a standardized form containing information about patients, methods, interventions, outcomes, and adverse events provided in the articles. Figure 1 Open in figure viewer PowerPoint. Systematic literature search overview. Cointerventions In regard to additional treatments, each study stated that patients received supplementary antiarrhythmic agents, such as amiodarone or digoxin, prior to, during, or after electric cardioversion based on either previous antiarrhythmic use or the discretion of the attending physician.
Quality The overall risk of bias was considered unclear in nine studies. Figure 2 Open in figure viewer PowerPoint. Figure 3 Open in figure viewer PowerPoint.
Forest plot of the effect of anteroposterior versus anterolateral pad placement on restoring normal sinus rhythm after the first shock in patients with atrial fibrillation or flutter. Secondary Outcomes Successful Conversion After the Final Shock of the Shock Protocol Because in most cases patients did not successfully return to normal sinus rhythm after their first shocks, they underwent multiple shocks before conversion was accomplished.
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Figure 4 Open in figure viewer PowerPoint. Forest plot of the overall cardioversion success of anteroposterior versus anterolateral pad placement in patients with atrial fibrillation or flutter. Crossover Success Six studies with participants used crossover shocks when patients failed to return to normal sinus rhythm after the initial shock protocol. Shock Energies The effect of shock energies on cumulative cardioversion success rates was examined.
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Subgroup and Sensitivity Analyses The influence of age, sex, and race on conversion to normal sinus rhythm could not be fully examined in subgroups due to incomplete outcome reporting. Figure 5 Open in figure viewer PowerPoint.
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Limitations There are several limitations that need to be discussed. Conclusions The published literature is restricted to persistent atrial fibrillation and flutter, is of low methodologic quality, employs variability in pad placement, and uses energy levels lower than currently recommended. Exact search strings. Google Scholar. PubMed Google Scholar. Volume 21 , Issue 7 July Pages Figures References Related Information. Close Figure Viewer. Browse All Figures Return to Figure.
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