Atrial fibrillation is a cardiac arrhythmia characterized by a complete irregularity in the electrical activation of the atria. In the course of atrial fibrillation the risk of stroke has been demonstrated to increase. The external electrical cardioversion is able to restore the heart’s electrical sinus rhythm in patients with atrial fibrillation and atrial flutter.
The position of the electrodes during cardioversion is not uniquely defined, with variable possibilities, especially after the indroduction of self-adhesive disposable plates. To address this question a literature search of PubMed, CINAHL, and Cochrane was performed and the 6 most important papers on the subject were reviewed.
For electrical cardioversion the use of anterior-posterior position of the plates, in particular when using a monophasic defibrillator, showed an advantage. When using a biphasic defibrillator, the position of the electrodes seems to be less influent. A weak advantage is seen in the treatment of atrial flutter using the front side.