RecruitingNAINTERVENTIONAL

Anteroposterior Versus Anterolateral Electrode Position for Electrical Cardioversion of Atrial Fibrillation

This study is investigating the best way to perform a common heart procedure called electrical cardioversion for people with atrial fibrillation or flutter. Electrical cardioversion uses small electrical shocks to reset an irregular heartbeat. We want to find out if placing the sticky pads (electrodes) on the chest in a front-to-side position is better than a front-to-back position. We're also checking if gently pressing on these pads improves how well the treatment works. The goal is to make this procedure more effective, hopefully reducing the need for more complex treatments later on and improving patients' quality of life.

At a glance

Status

Recruiting

Phase

Sponsor

McMaster University

Enrolment target

1,500

Start

22 Feb 2023

Estimated completion

01 Jul 2027

Atrial Fibrillation Atrial Flutter

What is this study about?

Atrial fibrillation is a very common condition where the heart's upper chambers beat irregularly. This can cause problems like tiredness, breathlessness, and increases the risk of strokes or heart failure. To help the heart get back to a regular rhythm, doctors often use a procedure called electrical cardioversion. This is where small electric shocks are delivered to the chest using special sticky pads.

We know that electrical cardioversion is generally a safe and effective way to restart a normal heart rhythm. However, we're still learning the best ways to do it. This study focuses on two main things: where to put the sticky pads on your chest, and whether applying gentle pressure to these pads makes the treatment more successful. Our previous research suggests these simple changes might improve how well cardioversion works, and we want to confirm this with a larger, more detailed study.

If our study shows that a particular pad placement or applying pressure helps, these straightforward techniques could be used worldwide. Since many thousands of cardioversions are performed every year, making even small improvements could mean many more people get back to a normal heart rhythm with fewer complications, potentially avoiding the need for more medicines or invasive procedures.

Key takeaways

Improving a common heart procedure for atrial fibrillation.
Testing two different ways to place sticky pads on the chest.
Investigating if gentle pressure on pads helps restart the heart.
Aims for more successful heart rhythm restoration.
Could lead to simpler, more effective treatment for many.

Who may be eligible?

This study is looking for adults who are already scheduled to have an electrical cardioversion for their atrial fibrillation or atrial flutter. This means you would be having the procedure at a planned time, not as an emergency.

However, there are some reasons why you might not be able to join. For example, if your blood-thinning medication isn't at the right level to safely have the procedure, or if you haven't had a special scan (called a trans-oesophageal echocardiogram) to check for blood clots in your heart. Also, if you have certain skin conditions or wounds on your chest where the sticky pads normally go, you wouldn't be able to take part.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you an adult (18 years or older)?
Are you already scheduled for an electrical cardioversion for atrial fibrillation or flutter?
Do you have appropriate blood-thinning medication as advised by your doctor?
Do you have healthy skin on your chest where the sticky pads would be placed?

Answer every question to see your result.

What does participation involve?

If you decide to take part in this study, after a full explanation and once you've given your permission, your doctor will perform your electrical cardioversion just as planned. The main difference is that we will carefully choose where to place the sticky pads on your chest – either front-to-side or front-to-back – chosen randomly, like flipping a coin. If your heart doesn't return to a normal rhythm after the first shock, the study will then randomly decide if gentle pressure is applied to the pads for the next shock. We will use standard heart monitoring (ECGs) to see if your heart rhythm returns to normal. Your participation will only involve the time during your cardioversion procedure itself, with no extra visits or follow-up beyond your usual medical care.

Potential risks and benefits

Participating in this study might help us discover better ways to perform electrical cardioversion, which could benefit many patients in the future. For you personally, the procedure is already planned, and we are just testing an adjustment to the technique, so there's no major change to your treatment plan. The risks involved are generally the same as those for a standard electrical cardioversion, including minor skin irritation from the pads or, rarely, other complications. You are free to withdraw from the study at any time without affecting your medical care.

Locations (2)

Hamilton Health Sciences
Verified postcode
Hamilton, Canada· Recruiting
St Joseph's Healthcare Hamilton
Verified postcode
Hamilton, Canada· Recruiting

Common questions

What is atrial fibrillation?

It's a common condition where the top chambers of your heart beat irregularly, which can make you feel tired or breathless.

What is electrical cardioversion?

It's a procedure where doctors use small electric shocks to gently reset your heart to a normal rhythm.

Will I feel the shocks?

No, you will be given medication to make you sleep during the procedure, so you won't feel any pain or discomfort.

Why are you studying pad placement?

We want to find the best position for the sticky pads on your chest to make the electrical cardioversion more effective.

What is 'manual pressure' in this study?

It refers to whether gently pressing on the sticky pads during the shock helps the treatment work better.

How to find out more

William McIntyre, MD

william.mcintyre@phri.ca 9055212100 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.