ArticleCJC open2026
MAX-SHOCK: A Pragmatic Randomized Controlled Trial Comparing Biphasic Defibrillators Used in Routine Cardioversion of Atrial Fibrillation.
Article in CJC open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06556667 (Comparison of Maximum Energy Shocks From Two Defibrillator Vendors MAX - SHOCK- A Randomized Controlled Clinical Trial), which is not on this map. Not yet cited in PubMed.
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.
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.
Comparison of Maximum Energy Shocks From Two Defibrillator Vendors MAX - SHOCK- A Randomized Controlled Clinical Trial
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Atrial fibrillation (AF) frequently requires rhythm control with electrical cardioversion, with approximately 10%-20% of patients undergoing electrical cardioversion 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 in not only maximum energy output but also proprietary waveform characteristics and impedance-compensation algorithms, factors that may independently influence cardioversion success. To date, these devices have not been compared directly in a randomized clinical trial.The maximum energy shocks trial is a single-centre, prospective, randomized, single-blinded controlled study comparing 2 widely used external defibrillators: the Physio-Control LIFEPAK 20 (Physio Control, location), capable of delivering up to 360 J, and the ZOLL Medical R-Series (ZOLL Medical, Chelmsford, MA), with a maximum programmable energy of 200 J. Rather than isolating shock energy alone, the trial evaluates real-world device performance, recognizing that waveform design and adaptive algorithms differ among 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 (aged ≥ 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 2 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. Clinical Trial Registration: NCT06556667.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.