Evidence map›Paper›PMID 34556559›Full record

ArticleOpen heart2021

Investigating the efficacy of chest pressure for direct current cardioversion in atrial fibrillation: a randomised control trial protocol (Pressure-AF).

David Ferreira, Philo Mikhail, Michael McGee, Andrew Boyle, Aaron Sverdlov, Maged William, Nicholas Jackson, Malcolm Barlow, James Leitch, Nicholas Collins and 2 more

Abstract readClinical Trial Protocol
In one paragraph

Article in Open heart, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Active Compression During External Cardioversion of Atrial Fibrillation: A Meta-Analysis of Randomized Controlled Trials.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2025
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

David FerreiraDepartment of Cardiology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia david.ferreira@health.nsw.gov.au.ORCID 0000-0003-3142-4503
Philo MikhailDepartment of Cardiology, Gosford Hospital, Gosford, New South Wales, Australia.
Michael McGeeSchool of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.
Andrew BoyleDepartment of Cardiology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia.
Aaron SverdlovDepartment of Cardiology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia.
Maged WilliamDepartment of Cardiology, Gosford Hospital, Gosford, New South Wales, Australia.
Nicholas JacksonDepartment of Cardiology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia.
Malcolm BarlowDepartment of Cardiology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia.
James LeitchDepartment of Cardiology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia.
Nicholas CollinsDepartment of Cardiology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia.
Thomas FordSchool of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.ORCID 0000-0003-4009-6652
Bradley WilsmoreDepartment of Cardiology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAtrial fibrillation (AF) is the most common sustained arrhythmia worldwide. Direct current cardioversion is commonly used to restore sinus rhythm in patients with AF. Chest pressure may improve cardioversion success through decreasing transthoracic impedance and increasing cardiac energy delivery. We aim to assess the efficacy and safety of routine chest pressure with direct current cardioversion for AF. METHODS AND ANALYSIS: Multicentre, double blind (patient and outcome assessment), randomised clinical trial based in New South Wales, Australia. Patients will be randomised 1:1 to control and interventional arms. The control group will receive four sequential biphasic shocks of 150 J, 200 J, 360 J and 360 J with chest pressure on the last shock, until cardioversion success. The intervention group will receive the same shocks with chest pressure from the first defibrillation. Pads will be placed in an anteroposterior position. Success of cardioversion will be defined as sinus rhythm at 1 min after shock. The primary outcome will be total energy provided. Secondary outcomes will be success of first shock to achieve cardioversion, transthoracic impedance and sinus rhythm at post cardioversion ECG. ETHICS AND DISSEMINATION: Ethics approval has been confirmed at all participating sites via the Research Ethics Governance Information System. The trial has been registered on the Australia New Zealand Clinical Trials Registry (ACTRN12620001028998). De-identified patient level data will be available to reputable researchers who provide sound analysis proposals.

Indexed as

ElectrocardiographyAtrial AppendageAtrial FibrillationDouble-Blind MethodEchocardiography, TransesophagealElectric CountershockFollow-Up StudiesHeart RateHumansIncidenceMulticenter Studies as TopicNew South WalesPressureProspective StudiesRandomized Controlled Trials as TopicThoracic Wallarrhythmiasatrial fibrillationcardiacelectrophysiology

Identifiers

PMID34556559
PMCPMC8461712

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.