“…The outcome of the procedure can be affected by multiple factors, including AF duration, position and size of electrodes, left atrial (LA) diameter, patients' body features, and transthoracic impedance [1][2][3]. Although several modifications of standard DCCV were implemented to improve its effectiveness, including the transesophageal approach, vector-change, and dual DC shocks [4][5], it still can be challenging in obese or extremely large individuals.…”