title: Anterior-posterior versus anterior-lateral electrode position for external electrical cardioversion of atrial fibrillation: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Several clinical trials have shown inconsistent results regarding the effect of electrode positions on the success of electrical cardioversion.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of cardiology, The Affiliated People's hospital of Jiangsu university, 8 Dianli road, Zhenjiang, Jiangsu 212002, China.
authors.forename: Baowei
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of cardiology, The Affiliated People's hospital of Jiangsu university, 8 Dianli road, Zhenjiang, Jiangsu 212002, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of cardiology, The Affiliated People's hospital of Jiangsu university, 8 Dianli road, Zhenjiang, Jiangsu 212002, China.
authors.forename: Dongli
authors.initials: D
authors.lastname: Shen
authors.affiliation: Department of cardiology, The Affiliated People's hospital of Jiangsu university, 8 Dianli road, Zhenjiang, Jiangsu 212002, China.
authors.forename: Ya
authors.initials: Y
authors.lastname: Zhen
authors.affiliation: Department of cardiology, The Affiliated People's hospital of Jiangsu university, 8 Dianli road, Zhenjiang, Jiangsu 212002, China.
authors.forename: Aibin
authors.initials: A
authors.lastname: Tao
authors.affiliation: Department of cardiology, The Affiliated People's hospital of Jiangsu university, 8 Dianli road, Zhenjiang, Jiangsu 212002, China. Electronic address: guohuizhang2013@126.com.
authors.forename: Guohui
authors.initials: G
authors.lastname: Zhang
mesh_terms: D001281:Atrial Fibrillation / Q000473:pathology / Q000628:therapy*; D047548:Defibrillators; D004554:Electric Countershock / Q000379:methods*; D004566:Electrodes; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D009929:Organ Size; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: Atrial fibrillation; Cardioversion électrique; Electrical cardioversion; Electrode position; Fibrillation atriale; Meta-analysis; Méta-analyse; Position de l’électrode