Table 1

Study characteristics

ReferenceLocationSample sizeRecent onset or persistent
Inclusion criteriaExclusion criteriaShock protocol suggestsSuccessful cardioversion
Walsh et al 200525 England294PersistentElective cardioversion of stable AFOther arrhythmias, electrolyte imbalances or age <18 years70, 100, 150, 200JRestoration of sinus rhythm for at least 30 s after a shock
Siaplaouras et al 200523Germany123PersistentElective cardioversion of stable AFOther arrhythmias, pacemaker, potassium <3.5 or >5 mmol/L120, 150, 200JTermination of AF with at least two consecutive sinus beats after a shock
Brazdzionyte et al 200624 Lithuania103Recent onset/persistentElective cardioversion of stable AFAge <18 years.
Inadequate anticoagulation therapy*
100, 150, 200, 300J+crossoverPresence of at least one clearly visible P wave within 30 s after the administration of the shock
Muñoz-Martínez et al 201015Spain91PersistentElective cardioversion of persistent and stable AFAge <18 years, acute myocardial infarction, pregnancy, high risk of thromboembolism†150, 200, 200J+crossover‡After the final shock all patients were observed for 15 min at the intensive care unit and then moved back to the department and discharged with sinus rhythm after 2 hours if the patient was stable.
Schmidt et al 202126 Denmark467Recent onset/persistentElective cardioversion of stable AFAge <18 years, other arrhythmias, ICD, pregnancy or previous enrollment in protocol100, 150, 200, 360JSinus rhythm 1 min after first shock or 1 min after final shock.
  • *International normalised ratio >2 for at least 3 weeks before cardioversion.

  • †Inadequate anticoagulation therapy or verified auricular thrombus in echocardiography.

  • ‡As the energy level for second and third shock were similar, we counted the second shock as the final.

  • AF, atrial fibrillation; ICD, implantable cardioverter-defibrillator.