Optimization of Initial Energy for Cardioversion of Atrial Fibrillation With Biphasic Shocks

Optimization of Initial Energy for Cardioversion of Atrial Fibrillation With Biphasic Shocks (OPTIMA Trial).

Use of higher energy doses (120-150 J) may not offer additional benefits and higher success rate compared with low to moderate initial energy (100-120 J) of biphasic shock for atrial fibrillation cardioversion. In this prospective open-label randomized trial consecutive patients with AF and candidate to AF electrical cardioversion will be randomized to receive 100J or 120 J as initial dose of biphasic shock. Patients will be also randomized in each group to anterolateral or postero-anteriore placement of defibrillator electrodes.

Open-label randomized trial to assess the efficacy of alternative initial biphasic shocks (100 versus 120 J) for cardioversion of atrial fibrillation including alternative option for electrode placement (anterolateral or postero-anterior in each group).

Inclusion Criteria:

• Adult (Age>18 years)
• Candidate to Cardioversion for recent onset, persistent atrial fibrillation (>48 hours but < 12 months)
• Informed Consent

Exclusion Criteria:

• Atrial Flutter or other arrythmias