moayedi-et-al-anteroposterior-pacer-pad-position-is-more-likely-to-capture-than-anterolateral-for-tr
This Circulation research letter (Moayedi et al.) reports a prospective crossover study (clinicaltrials.gov NCT03898050) of 20 patients undergoing elective cardioversion, testing transcutaneous pacer pad placement in anteroposterior (AP) versus anterolateral (AL) positions. AP captured in 14/18 trials (78%) versus AL in 8/19 trials (42%); relative risk of capture for AP vs AL was 1.8 (95% CI 1.0–3.3). AP required on average 33 mA less current for capture (P=0.0001; 95% CI 20–45). The authors conclude AP positioning is more likely to capture and suggest guidelines may consider favoring AP for transcutaneous pacing, while noting logistical limitations and the need for larger studies.
Questions this document answers
September 2019 through February 2022
20 participants (6 female; 14 male)
14 of 18 trials (78%) captured in AP position
8 of 19 trials (42%) captured in AL position
1.8 (95% CI, 1.0–3.3)