The trial will evaluate whether the 360-J capable defibrillator leads to a higher success rate of cardioversion compared to the 200-J defibrillator in patients with atrial fibrillation.
Does the Physio-Control Lifepak 20 (360 J maximum) improve successful cardioversion rates in adults with persistent AF compared to the Zoll Medical R-Series (200 J maximum)?
The MAX-SHOCK trial is designed to provide the first randomized comparison of two widely used biphasic defibrillators with differing maximum energies (360 J vs 200 J) and waveforms for the routine cardioversion of atrial fibrillation.
Absolute Event Rate: 0% vs 0%
Atrial fibrillation (AF) frequently requires rhythm control with electrical cardioversion (ECV), with approximately 10-20% of patients undergoing ECV annually.Despite its widespread use, cardioversion failure remains common, and clinical practice varies considerably with respect to shock energy, pad positioning, and defibrillator technology.Commonly used biphasic defibrillators differ not only in maximum energy output but also in proprietary waveform characteristics and impedance-compensation algorithms, factors that may independently influence cardioversion success.To date, these devices have not been directly compared in a randomized clinical trial.The MAXSHOCK trial (NCT06556667) is a single-center, prospective, randomized, singleblinded controlled study comparing two widely used external defibrillators: the Physio-Control Lifepak 20, capable of delivering up to 360 Joules, and the Zoll Medical R-Series, with a maximum programmable energy of 200 Joules.Rather than isolating shock energy alone, the trial evaluates real-world device performance, recognizing that waveform design and adaptive algorithms differ between manufacturers.We hypothesize that the 360-J-capable defibrillator will be associated with a higher rate of successful cardioversion when used within a standardized stepwise protocol.Adults (18 years) with persistent AF scheduled for elective cardioversion are randomized in a single-blinded fashion.The primary outcome is successful cardioversion, defined as restoration of sinus rhythm with at least two consecutive sinus or atrial-paced beats.A total of 356 patients will be enrolled to assess superiority.This trial represents the first randomized comparison of real-world defibrillator system performance in AF cardioversion and will help inform future cardioversion protocols and defibrillator selection.
Golian et al. (Sun,) reported a other. The trial will evaluate whether the 360-J capable defibrillator leads to a higher success rate of cardioversion compared to the 200-J defibrillator in patients with atrial fibrillation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: