Electrical cardioversion and defibrillation with self-adhesive patches compared to paddle electrodes in adult patients. Scoping review

Introduction: The incidence of cardiac arrest in the United Kingdom is of 55 per 100.000 inhabitants. Of these, only one of every ten patients has access to a defibrillator and shockable rhythm is identified in one of every four patients. Defibrillation is one of the key links in the management of both basic and advanced resuscitation. Objective: This scoping review aims at reviewing the literature focusing on the effectiveness on self-adhesive patches in electrical therapy for cardiac arrest and the electrical instability in the adult hospital environment. Methods: Searches were conducted in Medline and Embase until January, 2024, including primary trials (excluding case series and animal studies) and systematic reviews. The participants were hospitalized adult patients requiring electrical cardioversion or defibrillation. The intervention assessed involved the use of self-adhesive patches versus paddle electrodes, to measure effectiveness and safety. The searches were conducted using controlled and non-controlled terms, excluding grey literature. Two of the authors independently reviewed the titles and abstracts and settled any disagreements by consensus. Relevant data were extracted and synthetized on one table for an overall qualitative summary of the outcomes. Results: Ten references were identified in the literature search. After ruling out duplicates, nine references were reviewed based on title and abstract. Three studies met the inclusion criteria and the complete text was screened. No studies were found which conclusively concluded the effectiveness of self-adhesive patches used in electrical therapy for hospital resuscitation. The studies included fail to discuss safety results of the interventions. Conclusion: When mapping the topics of intervention, this scoping review has identified the need for further systematic research on the effectiveness of self-adhesive patches for electrical cardioversion and defibrillation in hospital settings. Notwithstanding the evidence supporting electrical therapy to revert unstable tachyarrhythmias and ventricular fibrillation/pulseless ventricular tachycardia, further studies are needed comparing paddle electrodes versus self-adhesive patches in the hospital setting. Future prospective trials are required to establish the comparative effectiveness of these methods in the hospital management of cardioversion/defibrillation.