<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03827915</url>
  </required_header>
  <id_info>
    <org_study_id>BIO-2017-0457</org_study_id>
    <nct_id>NCT03827915</nct_id>
  </id_info>
  <brief_title>Double Sequential External Defibrillation in Patients With Atrial Fibrillation Refractory to DC Cardioversion</brief_title>
  <official_title>Double Sequence External Defibrillation: A Randomized Controlled Trial in Patients With Atrial Fibrillation Refractory to DC Cardioversion</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>American University of Beirut Medical Center</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>American University of Beirut Medical Center</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Atrial fibrillation (AF) is a common cardiac arrhythmia that leads to increased risk of heart&#xD;
      failure, hospitalization, thromboembolic events, and death. Restoration of normal heart&#xD;
      rhythm is performed in many patients with AF to improve symptoms. In this study, the&#xD;
      investigators will consider patients who fail 2 or more trials of DC cardioversion as having&#xD;
      refractory AF.&#xD;
&#xD;
      The aim of this study is to assess whether the use of double sequential defibrillation in&#xD;
      patients with refractory AF has a higher success rate in reverting them to a normal heart&#xD;
      rhythm than a third cardioversion.&#xD;
&#xD;
      This is a phase III, randomized controlled, single-centered, superiority trial. All patients&#xD;
      with AF admitted to the coronary care unit (CCU) for DC cardioversion, and refractory to at&#xD;
      least two trials of DC cardioversion will be enrolled. Patients are randomized into two arms:&#xD;
      the first will receive a third trial of DC cardioversion (standard of care) and the second&#xD;
      will receive double sequential external defibrillation.&#xD;
&#xD;
      The resolution of AF by reverting back to normal sinus rhythm is the primary outcome of the&#xD;
      investigators. This will be determined using EKG (electrocardiogram) immediately after DC&#xD;
      cardioversion or double sequential defibrillation.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Patients presenting to the CCU with persistent AF for direct current (DC) cardioversion, who&#xD;
      meet the inclusion criteria and fail to revert to normal sinus rhythm after two DC&#xD;
      cardioversion attempts will be invited for enrollment in the study. No sampling will be&#xD;
      carried out for the sake of this study.&#xD;
&#xD;
      Patients meeting the eligibility criteria will receive double sequential external&#xD;
      defibrillation (DSED) or a third DC cardioversion (standard of care).&#xD;
&#xD;
      DSED is the process of using two defibrillators near simultaneously at their highest allowed&#xD;
      energy setting and aims to treat refractory atrial fibrillation. The first set of pads is&#xD;
      placed in the traditional anterolateral position and the second set can be either placed&#xD;
      adjacent to the first set (antero-lateral) or in the antero-posterior position. Shocks are&#xD;
      then delivered simultaneously or near simultaneously.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Recruiting</overall_status>
  <start_date type="Actual">January 21, 2019</start_date>
  <completion_date type="Anticipated">January 21, 2024</completion_date>
  <primary_completion_date type="Anticipated">January 21, 2024</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <intervention_model_description>Phase III, randomized controlled, superiority trial, with two parallel groups, conducted in one academic medical center</intervention_model_description>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Number of participants with atrial fibrillation who revert back to normal sinus rhythm using Double Sequential External Defibrillation after two failed attempts of DC cardioversion.</measure>
    <time_frame>15 minutes</time_frame>
    <description>Number of participants with atrial fibrillation who revert back to normal sinus rhythm using Double Sequential External Defibrillation after two failed attempts of DC cardioversion . This will be determined using an EKG (Electrocardiogram) immediately after double sequential external defibrillation.</description>
  </primary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">100</enrollment>
  <condition>Atrial Fibrillation</condition>
  <condition>Defibrillators</condition>
  <condition>Persistent Atrial Fibrillation</condition>
  <arm_group>
    <arm_group_label>Third trial of DC cardioversion</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>Patients with atrial fibrillation who fail to revert to sinus rhythm after two failed DC cardioversion attempts will receive a third trial of DC cardioversion (Standard of care)</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Double sequential external defibrillation</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Patients with atrial fibrillation who fail to revert to sinus rhythm after two failed DC cardioversion attempts will receive DSED</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Double sequential external defibrillation</intervention_name>
    <description>DSED is the process of using two defibrillators near simultaneously at their highest allowed energy setting and aims to treat refractory atrial fibrillation. The first set of pads is placed in the traditional anterolateral position and the second set can be either placed adjacent to the first set (antero-lateral) or in the antero-posterior position. Shocks are then delivered simultaneously or near simultaneously</description>
    <arm_group_label>Double sequential external defibrillation</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
        - Atrial Fibrillation patients admitted to the CCU for DC cardioversion, and refractory to&#xD;
        at least two trials of DC cardioversion&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Patients with Atrial Fibrillation not requiring DC cardioversion&#xD;
&#xD;
          -  Patients with Atrial Fibrillation who reverted after a maximum of two trials of DC&#xD;
             cardioversion&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>N/A</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Gilbert Abou Dagher, M.D.</last_name>
    <role>Principal Investigator</role>
    <affiliation>American University of Beirut Medical Center</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Gilbert Abou Dagher, M.D.</last_name>
    <phone>00961-1-350000</phone>
    <phone_ext>6617</phone_ext>
    <email>ga66@aub.edu.lb</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Marwan Refaat, M.D.</last_name>
    <phone>00961-1-350000</phone>
    <phone_ext>5366</phone_ext>
    <email>mr48@aub.edu.lb</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>American University of Beirut Medical Center</name>
      <address>
        <city>Beirut</city>
        <country>Lebanon</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Gilbert Abou Dagher, M.D.</last_name>
      <phone>00961-1-350000</phone>
      <phone_ext>6617</phone_ext>
      <email>ga66@aub.edu.lb</email>
    </contact>
  </location>
  <location_countries>
    <country>Lebanon</country>
  </location_countries>
  <reference>
    <citation>Benjamin EJ, Wolf PA, D'Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998 Sep 8;98(10):946-52. doi: 10.1161/01.cir.98.10.946.</citation>
    <PMID>9737513</PMID>
  </reference>
  <reference>
    <citation>Chugh SS, Blackshear JL, Shen WK, Hammill SC, Gersh BJ. Epidemiology and natural history of atrial fibrillation: clinical implications. J Am Coll Cardiol. 2001 Feb;37(2):371-8. doi: 10.1016/s0735-1097(00)01107-4.</citation>
    <PMID>11216949</PMID>
  </reference>
  <reference>
    <citation>Patel NJ, Deshmukh A, Pant S, Singh V, Patel N, Arora S, Shah N, Chothani A, Savani GT, Mehta K, Parikh V, Rathod A, Badheka AO, Lafferty J, Kowalski M, Mehta JL, Mitrani RD, Viles-Gonzalez JF, Paydak H. Contemporary trends of hospitalization for atrial fibrillation in the United States, 2000 through 2010: implications for healthcare planning. Circulation. 2014 Jun 10;129(23):2371-9. doi: 10.1161/CIRCULATIONAHA.114.008201. Epub 2014 May 19.</citation>
    <PMID>24842943</PMID>
  </reference>
  <reference>
    <citation>Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001 May 9;285(18):2370-5. doi: 10.1001/jama.285.18.2370.</citation>
    <PMID>11343485</PMID>
  </reference>
  <reference>
    <citation>Mead GE, Elder AT, Flapan AD, Kelman A. Electrical cardioversion for atrial fibrillation and flutter. Cochrane Database Syst Rev. 2005 Jul 20;(3):CD002903. doi: 10.1002/14651858.CD002903.pub2.</citation>
    <PMID>16034878</PMID>
  </reference>
  <reference>
    <citation>Alam M, Thorstrand C. Left ventricular function in patients with atrial fibrillation before and after cardioversion. Am J Cardiol. 1992 Mar 1;69(6):694-6. doi: 10.1016/0002-9149(92)90169-y. No abstract available.</citation>
    <PMID>1536123</PMID>
  </reference>
  <reference>
    <citation>Xiong C, Sonnhag C, Nylander E, Wranne B. Atrial and ventricular function after cardioversion of atrial fibrillation. Br Heart J. 1995 Sep;74(3):254-60. doi: 10.1136/hrt.74.3.254.</citation>
    <PMID>7547019</PMID>
  </reference>
  <reference>
    <citation>Van Gelder IC, Crijns HJ, Blanksma PK, Landsman ML, Posma JL, Van Den Berg MP, Meijler FL, Lie KI. Time course of hemodynamic changes and improvement of exercise tolerance after cardioversion of chronic atrial fibrillation unassociated with cardiac valve disease. Am J Cardiol. 1993 Sep 1;72(7):560-6. doi: 10.1016/0002-9149(93)90352-d.</citation>
    <PMID>8362771</PMID>
  </reference>
  <reference>
    <citation>Jaakkola S, Lip GY, Biancari F, Nuotio I, Hartikainen JE, Ylitalo A, Airaksinen KE. Predicting Unsuccessful Electrical Cardioversion for Acute Atrial Fibrillation (from the AF-CVS Score). Am J Cardiol. 2017 Mar 1;119(5):749-752. doi: 10.1016/j.amjcard.2016.11.026. Epub 2016 Dec 2.</citation>
    <PMID>28017305</PMID>
  </reference>
  <reference>
    <citation>Levy S, Lauribe P, Dolla E, Kou W, Kadish A, Calkins H, Pagannelli F, Moyal C, Bremondy M, Schork A, et al. A randomized comparison of external and internal cardioversion of chronic atrial fibrillation. Circulation. 1992 Nov;86(5):1415-20. doi: 10.1161/01.cir.86.5.1415.</citation>
    <PMID>1423954</PMID>
  </reference>
  <reference>
    <citation>Kabukcu M, Demircioglu F, Yanik E, Minareci K, Ersel-Tuzuner F. Simultaneous double external DC shock technique for refractory atrial fibrillation in concomitant heart disease. Jpn Heart J. 2004 Nov;45(6):929-36. doi: 10.1536/jhj.45.929.</citation>
    <PMID>15655268</PMID>
  </reference>
  <reference>
    <citation>Chang MS, Inoue H, Kallok MJ, Zipes DP. Double and triple sequential shocks reduce ventricular defibrillation threshold in dogs with and without myocardial infarction. J Am Coll Cardiol. 1986 Dec;8(6):1393-405. doi: 10.1016/s0735-1097(86)80313-8.</citation>
    <PMID>3782643</PMID>
  </reference>
  <reference>
    <citation>Hoch DH, Batsford WP, Greenberg SM, McPherson CM, Rosenfeld LE, Marieb M, Levine JH. Double sequential external shocks for refractory ventricular fibrillation. J Am Coll Cardiol. 1994 Apr;23(5):1141-5. doi: 10.1016/0735-1097(94)90602-5.</citation>
    <PMID>8144780</PMID>
  </reference>
  <reference>
    <citation>Alaeddini J, Feng Z, Feghali G, Dufrene S, Davison NH, Abi-Samra FM. Repeated dual external direct cardioversions using two simultaneous 360-J shocks for refractory atrial fibrillation are safe and effective. Pacing Clin Electrophysiol. 2005 Jan;28(1):3-7. doi: 10.1111/j.1540-8159.2005.09155.x.</citation>
    <PMID>15660795</PMID>
  </reference>
  <reference>
    <citation>Saliba W, Juratli N, Chung MK, Niebauer MJ, Erdogan O, Trohman R, Wilkoff BL, Augostini R, Mowrey KA, Nadzam GR, Tchou PJ. Higher energy synchronized external direct current cardioversion for refractory atrial fibrillation. J Am Coll Cardiol. 1999 Dec;34(7):2031-4. doi: 10.1016/s0735-1097(99)00463-5.</citation>
    <PMID>10588220</PMID>
  </reference>
  <reference>
    <citation>Hajjar K, Berbari I, El Tawil C, Bou Chebl R, Abou Dagher G. Dual defibrillation in patients with refractory ventricular fibrillation. Am J Emerg Med. 2018 Aug;36(8):1474-1479. doi: 10.1016/j.ajem.2018.04.060. Epub 2018 Apr 30.</citation>
    <PMID>29730094</PMID>
  </reference>
  <verification_date>January 2019</verification_date>
  <study_first_submitted>January 28, 2019</study_first_submitted>
  <study_first_submitted_qc>January 31, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">February 4, 2019</study_first_posted>
  <last_update_submitted>January 31, 2019</last_update_submitted>
  <last_update_submitted_qc>January 31, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">February 4, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Atrial fibrillation</keyword>
  <keyword>Refractory atrial fibrillation</keyword>
  <keyword>Double sequential external defibrillation</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Atrial Fibrillation</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <provided_document_section>
    <provided_document>
      <document_type>Study Protocol, Statistical Analysis Plan, and Informed Consent Form</document_type>
      <document_has_protocol>Yes</document_has_protocol>
      <document_has_icf>Yes</document_has_icf>
      <document_has_sap>Yes</document_has_sap>
      <document_date>January 31, 2019</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/15/NCT03827915/Prot_SAP_ICF_000.pdf</document_url>
    </provided_document>
  </provided_document_section>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03827915
org study id: BIO-2017-0457
nct id: NCT03827915
lead sponsor: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
Atrial fibrillation (AF) is a common cardiac arrhythmia that leads to increased risk of heart
      failure, hospitalization, thromboembolic events, and death. Restoration of normal heart
      rhythm is performed in many patients with AF to improve symptoms. In this study, the
      investigators will consider patients who fail 2 or more trials of DC cardioversion as having
      refractory AF.

      The aim of this study is to assess whether the use of double sequential defibrillation in
      patients with refractory AF has a higher success rate in reverting them to a normal heart
      rhythm than a third cardioversion.

      This is a phase III, randomized controlled, single-centered, superiority trial. All patients
      with AF admitted to the coronary care unit (CCU) for DC cardioversion, and refractory to at
      least two trials of DC cardioversion will be enrolled. Patients are randomized into two arms:
      the first will receive a third trial of DC cardioversion (standard of care) and the second
      will receive double sequential external defibrillation.

      The resolution of AF by reverting back to normal sinus rhythm is the primary outcome of the
      investigators. This will be determined using EKG (electrocardiogram) immediately after DC
      cardioversion or double sequential defibrillation.
Patients presenting to the CCU with persistent AF for direct current (DC) cardioversion, who
      meet the inclusion criteria and fail to revert to normal sinus rhythm after two DC
      cardioversion attempts will be invited for enrollment in the study. No sampling will be
      carried out for the sake of this study.

      Patients meeting the eligibility criteria will receive double sequential external
      defibrillation (DSED) or a third DC cardioversion (standard of care).

      DSED is the process of using two defibrillators near simultaneously at their highest allowed
      energy setting and aims to treat refractory atrial fibrillation. The first set of pads is
      placed in the traditional anterolateral position and the second set can be either placed
      adjacent to the first set (antero-lateral) or in the antero-posterior position. Shocks are
      then delivered simultaneously or near simultaneously.
allocation: Randomized
intervention model: Parallel Assignment
intervention model description: Phase III, randomized controlled, superiority trial, with two parallel groups, conducted in one academic medical center
primary purpose: Treatment
masking: None (Open Label)
measure: Number of participants with atrial fibrillation who revert back to normal sinus rhythm using Double Sequential External Defibrillation after two failed attempts of DC cardioversion.
time frame: 15 minutes
description: Number of participants with atrial fibrillation who revert back to normal sinus rhythm using Double Sequential External Defibrillation after two failed attempts of DC cardioversion . This will be determined using an EKG (Electrocardiogram) immediately after double sequential external defibrillation.
arm group label: Third trial of DC cardioversion
arm group type: No Intervention
description: Patients with atrial fibrillation who fail to revert to sinus rhythm after two failed DC cardioversion attempts will receive a third trial of DC cardioversion (Standard of care)
arm group label: Double sequential external defibrillation
arm group type: Experimental
description: Patients with atrial fibrillation who fail to revert to sinus rhythm after two failed DC cardioversion attempts will receive DSED
intervention type: Device
intervention name: Double sequential external defibrillation
description: DSED is the process of using two defibrillators near simultaneously at their highest allowed energy setting and aims to treat refractory atrial fibrillation. The first set of pads is placed in the traditional anterolateral position and the second set can be either placed adjacent to the first set (antero-lateral) or in the antero-posterior position. Shocks are then delivered simultaneously or near simultaneously
arm group label: Double sequential external defibrillation
criteria: 
gender: All
minimum age: N/A
maximum age: N/A
healthy volunteers: No
last name: Gilbert Abou Dagher, M.D.
role: Principal Investigator
affiliation: American University of Beirut Medical Center
last name: Gilbert Abou Dagher, M.D.
phone: 00961-1-350000
phone ext: 6617
email: ga66@aub.edu.lb
last name: Marwan Refaat, M.D.
phone: 00961-1-350000
phone ext: 5366
email: mr48@aub.edu.lb
facility: 
status: Recruiting
contact: 
country: Lebanon
citation: Benjamin EJ, Wolf PA, D'Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998 Sep 8;98(10):946-52. doi: 10.1161/01.cir.98.10.946.
PMID: 9737513
citation: Chugh SS, Blackshear JL, Shen WK, Hammill SC, Gersh BJ. Epidemiology and natural history of atrial fibrillation: clinical implications. J Am Coll Cardiol. 2001 Feb;37(2):371-8. doi: 10.1016/s0735-1097(00)01107-4.
PMID: 11216949
citation: Patel NJ, Deshmukh A, Pant S, Singh V, Patel N, Arora S, Shah N, Chothani A, Savani GT, Mehta K, Parikh V, Rathod A, Badheka AO, Lafferty J, Kowalski M, Mehta JL, Mitrani RD, Viles-Gonzalez JF, Paydak H. Contemporary trends of hospitalization for atrial fibrillation in the United States, 2000 through 2010: implications for healthcare planning. Circulation. 2014 Jun 10;129(23):2371-9. doi: 10.1161/CIRCULATIONAHA.114.008201. Epub 2014 May 19.
PMID: 24842943
citation: Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001 May 9;285(18):2370-5. doi: 10.1001/jama.285.18.2370.
PMID: 11343485
citation: Mead GE, Elder AT, Flapan AD, Kelman A. Electrical cardioversion for atrial fibrillation and flutter. Cochrane Database Syst Rev. 2005 Jul 20;(3):CD002903. doi: 10.1002/14651858.CD002903.pub2.
PMID: 16034878
citation: Alam M, Thorstrand C. Left ventricular function in patients with atrial fibrillation before and after cardioversion. Am J Cardiol. 1992 Mar 1;69(6):694-6. doi: 10.1016/0002-9149(92)90169-y. No abstract available.
PMID: 1536123
citation: Xiong C, Sonnhag C, Nylander E, Wranne B. Atrial and ventricular function after cardioversion of atrial fibrillation. Br Heart J. 1995 Sep;74(3):254-60. doi: 10.1136/hrt.74.3.254.
PMID: 7547019
citation: Van Gelder IC, Crijns HJ, Blanksma PK, Landsman ML, Posma JL, Van Den Berg MP, Meijler FL, Lie KI. Time course of hemodynamic changes and improvement of exercise tolerance after cardioversion of chronic atrial fibrillation unassociated with cardiac valve disease. Am J Cardiol. 1993 Sep 1;72(7):560-6. doi: 10.1016/0002-9149(93)90352-d.
PMID: 8362771
citation: Jaakkola S, Lip GY, Biancari F, Nuotio I, Hartikainen JE, Ylitalo A, Airaksinen KE. Predicting Unsuccessful Electrical Cardioversion for Acute Atrial Fibrillation (from the AF-CVS Score). Am J Cardiol. 2017 Mar 1;119(5):749-752. doi: 10.1016/j.amjcard.2016.11.026. Epub 2016 Dec 2.
PMID: 28017305
citation: Levy S, Lauribe P, Dolla E, Kou W, Kadish A, Calkins H, Pagannelli F, Moyal C, Bremondy M, Schork A, et al. A randomized comparison of external and internal cardioversion of chronic atrial fibrillation. Circulation. 1992 Nov;86(5):1415-20. doi: 10.1161/01.cir.86.5.1415.
PMID: 1423954
citation: Kabukcu M, Demircioglu F, Yanik E, Minareci K, Ersel-Tuzuner F. Simultaneous double external DC shock technique for refractory atrial fibrillation in concomitant heart disease. Jpn Heart J. 2004 Nov;45(6):929-36. doi: 10.1536/jhj.45.929.
PMID: 15655268
citation: Chang MS, Inoue H, Kallok MJ, Zipes DP. Double and triple sequential shocks reduce ventricular defibrillation threshold in dogs with and without myocardial infarction. J Am Coll Cardiol. 1986 Dec;8(6):1393-405. doi: 10.1016/s0735-1097(86)80313-8.
PMID: 3782643
citation: Hoch DH, Batsford WP, Greenberg SM, McPherson CM, Rosenfeld LE, Marieb M, Levine JH. Double sequential external shocks for refractory ventricular fibrillation. J Am Coll Cardiol. 1994 Apr;23(5):1141-5. doi: 10.1016/0735-1097(94)90602-5.
PMID: 8144780
citation: Alaeddini J, Feng Z, Feghali G, Dufrene S, Davison NH, Abi-Samra FM. Repeated dual external direct cardioversions using two simultaneous 360-J shocks for refractory atrial fibrillation are safe and effective. Pacing Clin Electrophysiol. 2005 Jan;28(1):3-7. doi: 10.1111/j.1540-8159.2005.09155.x.
PMID: 15660795
citation: Saliba W, Juratli N, Chung MK, Niebauer MJ, Erdogan O, Trohman R, Wilkoff BL, Augostini R, Mowrey KA, Nadzam GR, Tchou PJ. Higher energy synchronized external direct current cardioversion for refractory atrial fibrillation. J Am Coll Cardiol. 1999 Dec;34(7):2031-4. doi: 10.1016/s0735-1097(99)00463-5.
PMID: 10588220
citation: Hajjar K, Berbari I, El Tawil C, Bou Chebl R, Abou Dagher G. Dual defibrillation in patients with refractory ventricular fibrillation. Am J Emerg Med. 2018 Aug;36(8):1474-1479. doi: 10.1016/j.ajem.2018.04.060. Epub 2018 Apr 30.
PMID: 29730094
responsible party type: Sponsor
mesh term: Atrial Fibrillation
sharing ipd: No
provided document: 