Randomized, patient-blinded, multicenter clinical trial (August 2020–2023) comparing dual direct-current cardioversion (dual DCCV: two simultaneous 200‑J shocks via two pad sets) vs standard single 200‑J DCCV as initial therapy for atrial fibrillation in adults with obesity (BMI ≥35). 200 patients completed the study (median age 67.6 years; mean BMI ~41.2). Dual DCCV produced higher immediate cardioversion success after the first attempt (97/99, 98%) than single DCCV (87/101, 86%; P=.002) without increased complications or chest discomfort. Trial registered at ClinicalTrials.gov (NCT04539158); published online May 22, 2024 (doi:10.1001/jamacardio.2024.1091).

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NCT04539158

May 22, 2024

10.1001/jamacardio.2024.1091

August 2020 to 2023

200

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