# Maximum-vaste-energie schokken voor AF-cardioversie

*geplaatst 2020-02-01 · Atriumfibrilleren · European heart journal · doi 10.1093/eurheartj/ehz585 · https://hartvaat.nl/2020/02/01/maximum-vaste-energie-schokken-voor-af-cardioversie/*

Studie naar het gebruik van maximale vaste energieschokken voor cardioversie van AF. Efficiëntie versus stapsgewijze energieverhoging.

## English: Maximum-fixed energy shocks for cardioverting atrial fibrillation.

This study showed that maximum-fixed energy shocks for AF cardioversion are safe and more efficient than low-escalating energy protocols, supporting a simplified first-shock-at-maximum approach.

## Abstract (original, from the publication)

AIMS: Direct-current cardioversion is one of the most commonly performed procedures in cardiology. Low-escalating energy shocks are common practice but the optimal energy selection is unknown. We compared maximum-fixed and low-escalating energy shocks for cardioverting atrial fibrillation. METHODS AND RESULTS: In a single-centre, single-blinded, randomized trial, we allocated elective atrial fibrillation patients to cardioversion using maximum-fixed (360-360-360 J) or low-escalating (125-150-200 J) biphasic truncated exponential shocks. The primary endpoint was sinus rhythm 1 min after cardioversion. Safety endpoints were any arrhythmia, myocardial injury, skin burns, and patient-reported pain after cardioversion. We randomized 276 patients, and baseline characteristics were well-balanced between groups (mean ± standard deviation age: 68 ± 9 years, male: 72%, atrial fibrillation duration >1 year: 30%). Sinus rhythm 1 min after cardioversion was achieved in 114 of 129 patients (88%) in the maximum-fixed energy group, and in 97 of 147 patients (66%) in the low-escalating energy group (between-group difference; 22 percentage points, 95% confidence interval 13-32, P < 0.001). Sinus rhythm after first shock occurred in 97 of 129 patients (75%) in the maximum-fixed energy group compared to 50 of 147 patients (34%) in the low-escalating energy group (between-group difference; 41 percentage points, 95% confidence interval 30-51). There was no significant difference between groups in any safety endpoint. CONCLUSION: Maximum-fixed energy shocks were more effective compared with low-escalating energy shocks for cardioverting atrial fibrillation. We found no difference in any safety endpoint.

Auteurs: Anders S Schmidt, Kasper G Lauridsen, Peter Torp, Leif F Bach, Hans Rickers, Bo Løfgren

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehz585. Bijgewerkt 2026-07-03T13:27:34Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.