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This article is about mains power connection devices used in domestic and light commercial environments. For other types, see. Plugs and sockets for electrical appliances not hardwired to mains electricity originated in in the 1880s and were initially two-pin designs.

These were usually sold as a mating pair, but gradually de facto and then official standards arose to enable the interchange of compatible devices. British standards have proliferated throughout large parts of the former. BS 546, Two-pole and earthing-pin plugs, socket-outlets and socket-outlet adaptors for AC (50-60 Hz) circuits up to 250 V is a for three pin.

Originally published in April 1934, it was updated by a 1950 edition which is still current, with eight amendments up to 1999. BS 546 is also the precursor of current Indian and South African plug standards. The 5 A version has been designated as Type D and the 15 A as Type M. BS 546 plugs and sockets are still permitted in the UK, provided the socket has shutters. BS 1363, 13 A plugs socket-outlets adaptors and connection units is a which specifies the most common type of single-phase that are used in the. Distinctive characteristics of the system are shutters on the neutral and line (see Concepts and Terminology below) socket holes, and a fuse in the plug. It has been adopted in many former.

BS 1363 was introduced in 1947 as one of the new standards for used for reconstruction. The plug and socket replaced the plug and socket, which are still found in old installations or in special applications. BS 1363 plugs have been designated as Type G. Contents • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Concepts and terminology [ ] The publishes IEC 60050, the International Electrotechnical Vocabulary, which is also available as. Generally the plug is the movable connector attached to an electrically operated device's, and the socket is fixed on equipment or a building structure and connected to an energised electrical circuit. The plug has protruding pins (referred to as ) that fit into matching apertures (called ) in the sockets. A plug is defined in IEC 60050 as an accessory having pins designed to engage with the contacts of a socket-outlet, also incorporating means for the electrical connection and mechanical retention of flexible cables or cords, a plug does not contain components which modify the electrical output from the electrical input (except where a switch or fuse is provided as a means of disconnecting the output from input).

There is an erroneous tendency to refer to power conversion devices with incorporated plug pins as plugs, but IEC 60050 refers to these as 'direct plug-in equipment' defined as equipment in which the mains plug forms an integral part of the equipment enclosure so that the equipment is supported by the mains socket-outlet. Cracked Terminator 3 Deleted Scene. In this article, the term 'plug' is used in the sense defined by IEC 60050. Sockets are designed to prevent exposure of bare energised contacts. To reduce the risk of users accidentally touching energized conductors and thereby experiencing, plug and socket systems often incorporate safety features in addition to the recessed contacts of the energized socket. These include plugs with insulated sleeves, sockets with blocking shutters, and sockets designed to accept only compatible plugs inserted in the correct orientation.

The term plug is in general and technical use in all forms of English, common alternatives being power plug, electric plug, and plug top. The normal technical term for an AC power socket is socket-outlet, but in non-technical common use a number of other terms are used. The general term is socket, but there are numerous common alternatives, including power point, plug socket, wall socket, and wall plug. Modern British sockets for domestic use are normally manufactured as single or double units with an integral face plate and are designed to fit standard mounting boxes.

Electrical sockets for domestic, commercial and light industrial purposes generally provide three electrical connections to the supply conductors. These are termed neutral, line and earth.

Both neutral and line carry current and are defined as live parts. Neutral is usually at or very near to earth potential, being earthed either at the substation or at the service entrance (neutral-to-earth bonding is not permitted in the distribution board/consumer unit). [ ] Line (commonly, but technically incorrectly, called live) carries the full supply voltage relative to the neutral. The protective earth connection allows the exposed metal parts of the appliance to be connected to earth, providing protection to the user should those exposed parts inadvertently come into contact with any live parts within the appliance. Historically, two-pin sockets without earth were used in Britain, but their use is now restricted to sockets specifically designated for shavers and toothbrushes. An adaptor (in the context of plugs and sockets) is defined in IEC 60050 as a portable accessory constructed as an integral unit incorporating both a plug portion and one or more socket-outlet portions.

(There is an alternative spelling, adapter, but adaptor is the form usually used in standards and official documents.) Common characteristics [ ] There are certain characteristics common to British mains plugs and sockets intended for domestic use. The brass pins appear relatively solid and large compared to others. British Standards for plugs (with the exception of BS 4573) have always specified side entry flex (entry in other types is usually parallel to the axes of the pins). Since 1934, the contacts of a socket have been specified in terms of the pins of the plug, rather than by specifying the contact dimensions.

The pins of both round pin and rectangular pin plugs are arranged in a triangular fashion, the earth pin being the larger and longer pin at the apex. Earthed sockets are designed to be incompatible with two-pin plugs. Both BS 546 and BS 1363 sockets, when viewed from the front with the earth uppermost, have the line aperture at the lower right. British plugs and sockets regulatory system [ ] A, the Plugs and Sockets etc. (Safety) Regulations 1987 was introduced to specifically regulate plugs and sockets in the. This was revised by the Plugs and Sockets etc. (Safety) Regulations 1994.

The guidance notes to the 1994 regulations state: The Plugs and Sockets, etc. (Safety) Regulations 1994 (the “Regulations”) were introduced to provide a regulatory regime to address issues regarding consumer safety.

There were concerns that consumer safety was compromised by the substantial quantity of counterfeit and unsafe electrical plugs and sockets being placed on the UK market and also by the provision of electrical equipment without an appropriate means to connect it to the mains supply in the consumer’s home. The regulations include a requirement that all plug types must be tested and certified by a nominated approval body (normally, or ).

They also require that all mains appliances for domestic use in the UK are supplied with approved BS 1363 plugs, but there is an exception for plugs fitted to shavers and toothbrushes which are normally a UK shaver plug (BS 4573) but may also be a Europlug (BS EN 50075). The regulations also contain a provision for the approval of non-BS 1363 conforming plugs when 'the plugs are constructed using an alternative method of construction which provides an equivalent level of safety in respect of any risk of death or personal injury to plugs which conform to BS 1363 and is such that plugs of that type may reasonably be expected to be safe in use.' Certifying bodies have used this provision by developing their own standards for novel devices, thus allowing the introduction of innovative developments; an example is the plastic ISOD (insulated shutter opening device) which was originally approved against either an ASTA Standard or the BSI before becoming incorporated into BS 1363-1:1995. There is no regulation of domestic mains plugs and sockets; the specifically excludes domestic plugs and sockets.

EU countries each have their own regulations and national standards and CE marking is neither applicable nor permitted on plugs and sockets. Despite this CE Marking is sometimes fraudulently used, especially on universal sockets. Early history [ ]. Lampholder plug from 1893 GEC Ltd (London) Catalogue When was first introduced into houses, it was primarily used for lighting. As electricity became a common method of operating labour-saving appliances, a safe means of connection to the electric system other than using a light socket was needed. According to British Author John Mellanby the first plug and socket in England was introduced by T.T.

Smith in 1883, and there were two-pin designs by 1885, one of which appears in the catalogue of 1889. Gustav Binswanger, a German Jewish immigrant who founded the (British) General Electric Company Ltd, obtained a patent (GB189516898) in 1895 for a plug and socket using a concentric (co-axial) contact system.

The earthed consumer plug has several claimants to its invention. A 1911 book dealing with the electrical products of A. Lundberg & Sons of London describes the Tripin earthed plug available in 2.5 A and 5 A models. The pin configuration of the Tripin appears virtually identical to modern BS 546 plugs. In her 1914 book Electric cooking, heating, cleaning, etc Maud Lucas Lancaster mentions an earthed iron-clad plug and socket by the English firm of. The 1911 (GEC) Catalogue included several earthed sockets intended for industrial use.

British two-pin plugs and sockets [ ]. Early GEC 2 pin plug and socket as depicted in the 1893 GEC Catalogue The earliest domestic plug and socket is believed to be that patented by T.T. Smith in 1883. This was shortly followed by patents from WB Sayers and G Hookham; these early designs had rectangular plugs with contact plates on either side. In 1885, two-pin plug designs appeared and in 1889 there were two-pin plugs and sockets in the GEC catalogue. The 1893 GEC Catalogue included 3 sizes of what was described as Double plug Sockets with capacities described not in amps, but as 1 to 5 lights, 5 to 10 lights and 10 to 20 lights.

These were clearly recognisable as two-pin plugs and sockets, but with no indication as to pin size or spacing, they were sold as pairs. The same catalogue included lampholder plugs for both BC and ES lampholders (capacity unspecified), and also a type of two-pole concentric plug and socket (similar to a very large versions of the concentric connectors used for laptop PC power connections) in the 1 to 5 lights and 5 to 10 lights capacities. Crompton and Company introduced the first two-pin socket with protective shutters in 1893, the was also manufacturing two-pin plug and sockets in the 1890s. By the time the 1911 GEC Catalogue was published two pin plugs and sockets were being offered with specifications in amps, but still no indication as to pin size or spacing. The Midget Gauge was rated at 3 A, the Standard Gauge rated at 5 A, and the Union Gauge rated at 10 A.

Also offered were two-way and three-way 'T pieces' or multi-way adaptors for the 3 A and 5 A plugs, two way only for the 10 A. Versions of the concentric plug and socket were now offered rated at 5 A and 10 A. At the same time Lundberg were offering the 2.5 A Dot; 5 A Universal and 15 A Magnum, and Tucker were offering a range of 5 A, 10 A and 20 A plugs and sockets. BS 73 Wall plugs and sockets (five ampere two-pin without earthing connection) was first published in 1915, and revised in 1919 with the addition of 15 A and 30 A sizes. By the 1927 revision of BS 73 four sizes of two-pin plugs and sockets were standardized: 2 A, 5 A, 15 A and 30 A. This was later superseded by BS 372:1930 part 1 Two-pin Side-entry Wall Plugs And Sockets for Domestic Purposes.

Following the introduction of BS 4573 in 1970 there were no longer any UK domestic uses for two-pin sockets except for shavers, so BS 372 was renamed 'Two-pin Side-entry Wall Plugs And Sockets For Special Circuits' and subsequently withdrawn. Characteristics of BS 73:1927 (BS 372:1930 part 1) two-pin plugs Current rating 30 A 15 A 5 A 2 A Pin diameter 0.312 inches (7.9 mm) 0.278 inches (7.1 mm) 0.200 inches (5.1 mm) 0.140 inches (3.6 mm) Pin length 1.125 inches (28.6 mm) 0.812 inches (20.6 mm) 0.625 inches (15.9 mm) 0.500 inches (12.7 mm) Distance between pin centres 1.25 inches (32 mm) 0.875 inches (22.2 mm) 0.656 inches (16.7 mm) 0.473 inches (12.0 mm).

UK shaver socket marked with shaver symbol. Accepts BS 4573 plugs, also US, Australian and Europlugs. Dual voltage, with isolating transformer. BS 4573 British Standard Specification for two-pin reversible plugs and shaver socket-outlets defines a plug for use with electric shavers, the pin dimensions are the same as those of the 5 A plug specified in the obsolete BS 372:1930 part 1 (as shown in the table above). Unlike the original, the plug has insulated sleeves on the pins.

Electric toothbrushes in the UK are normally supplied with the same plug. The sockets for this plug are rated at (and limited to) 200 mA. BS 4573 has no explicit specification for the plug rating, but Sheet GB6 (BS 4573, dated 2002-06-03, written by BSI committee) of IEC 60083 states that a rating of 0.2 A applies to all BS 4573 accessories.

The BS 4573 socket is suitable for use in dry areas only, so is now rarely used. It is more usual to find shaver supply units meeting BS EN 61558-2-5 which include an and usually accept multiple two-pin plug types including BS 4573, and Australian.

The isolation transformer often includes a 115 V output, and will then accept two-pin also. Shaver supply units must also be current limited, BS EN 61558-2-5 specifies a minimum rating of 20 VA and maximum of 50 VA. BS 4573 and BS EN 61558-2-5 both require sockets to be marked with the shaver symbol defined in the IEC Standard, the words 'shavers only' are also often used but not required.

Illustration of 'Tripin' 3-pin earthed plug dated 1911. Note that the plug has the basic characteristics of the modern BS 546 plug, three round pins, the earth pin being longer and thicker than the other two, and with a side cable entry.

In the early 20th century, A. Lundberg & Sons of London manufactured the Tripin earthed plug available in 2.5 A and 5 A models. The Tripin is described in a 1911 book dealing with the electrical products of A. Lundberg & Sons and its pin configuration appears virtually identical to modern BS 546 plugs.

The first British standard for domestic three-pin plugs was BS 317 Hand-Shield and Side Entry Pattern Three-Pin Wall Plugs and Sockets (Two Pin and Earth Type) published in 1928. This was superseded in 1930 by BS 372 Side-Entry Wall Plugs and Sockets for Domestic Purposes Part II which states that there are only minor alterations from BS 317. In 1934, BS 372 Part II was in turn superseded by the first edition of BS 546 Two-Pole and Earthing-Pin Plugs and Socket Outlets.

BS 546:1934 clause 2 specifies interchangeability with BS 372 Part II which includes the same four plug and socket sizes. (BS 372 Part I was a standard for two-pin non-earthed plugs which were never included in BS 546 and which were incompatible due to different pin spacings.) Also in 1934 the 10th Edition of the IEE’s “Regulations for the Electrical Equipment of Buildings” introduced the requirement for all sockets to have an earth contact. Prior to BS 546, British Standards for domestic plugs and sockets included dimensional specifications for the socket contact tubes. In BS 546 there are no dimensions for socket contacts, instead they are required to make good contact with the specified plug pins.

Before the introduction of BS 317, GH Scholes Ltd (Wylex) introduced (in 1926) an alternative three-pin plug. In three sizes, 5 A, 10 A and 15 A with a round earth pin and rectangular live pins, a fused 13 A version of this continued to be available after the introduction of BS 1363, illustrating that BS 546 was not used exclusively at any time. Although still permitted by the, BS 546 sockets are no longer used for general purposes. Some of the varieties remain in use in other countries and in specialist applications such as.

When BS 546 was in common use domestically in the UK the standard did not require sockets to be shuttered, although many were. The current revision of the standard allows optional shutters similar to those of.

Current UK wiring regulations require socket outlets installed in homes to be shuttered. BS 546 3-pin plugs. Left to right: 15 A, 5 A and 2 A.

There are four ratings of plug and socket in BS 546, (2 A, 5 A, 15 A and 30 A). Each has the same general appearance but they are different physical sizes to prevent interchangeability, they use pin spacing which is also different from the two pin plugs specified in BS 372, so earthed plugs will not fit into unearthed sockets, and vice versa. Plugs fitted with BS 646 fuses have been optional since the original BS 546:1934 with maximum fuse ratings of 2 A in the 2 A plug, and 5 A in the 5 A, 15 A and 30 A plugs. In practice most BS 546 plugs are unfused with fused versions being unusual and expensive. The 15 (A) sockets were generally given a dedicated 15 A circuit.

Multiple 5 A sockets might be on a 15 A circuit, or each on a dedicated 5 A circuit. Lighting circuits fused at 5 A were generally used to feed the 2 A sockets. Adaptors were available from 15 A down to 5 A and from 5 A down to 2 A so in practice it was possible for an appliance with the smallest size of flex to be protected only by a 15 A fuse.

This is a similar level of protection to that seen for portable appliances in other countries, but less than the protection offered by the BS 1363 fused plug. The larger top pin is the earth connection, the left hand pin is neutral and the right hand pin is line when looking at a socket or at the rear of a plug. 2 ampere [ ] This plug was used to connect low power appliances (and to adaptors from the larger socket types).

It is sometimes still used to connect lamps to a lighting circuit. 5 ampere [ ]. 5 A switched socket-outlet to BS 546 This plug corresponds to Type D in the IEC table. In the UK it was used for moderate sized appliances, either on its own 5 A circuit or on a multi socket 15 A circuit, and also on many adaptors (both multi socket 5 A adaptors and adaptors that also had 15 A pins).

This 5 A plug, along with its 2 A cousin, is sometimes used in the for centrally switched domestic lighting circuits, in order to distinguish them from normal power circuits, this is quite common in hotel rooms. This plug was also once used in theatrical installations for the same reasons as the 15 A model below. 15 ampere [ ]. 15 A switched socket-outlet to BS 546 This plug corresponds to Type M in the IEC table. It is the largest in domestic use and is commonly used in the UK for indoor dimmable theatre and architectural lighting installations. 30 ampere [ ] The 30 A plug is the largest of the family.

This was used for high power industrial equipment up to 7.2 kW, such as industrial kitchen appliances, or dimmer racks for stage lighting. Plugs and sockets were usually of an industrial waterproof design with a screw locking ring on the plug to hold it in the socket against waterproof seals, and sockets often had a screw cap chained to them to be used when no plug was inserted to keep them waterproof. Use of the BS 546 30 A plugs and sockets diminished through the 1970s as they were replaced with (which later became IEC 60309) industrial combo plugs and sockets. Characteristics of BS 546 three-pin plugs [ ] BS 546:1950 (current version confirmed October 2012) specifies pin dimensions only in decimal fractions of an inch, as shown below.

The metric values are conversions provided here for convenience. Note, the original lengths of the line and neutral pins on the 15 and 5 amp versions were slightly longer at 0.812 inches (20.6 mm) and 0.625 inches (15.9 mm) respectively. Left: a typical moulded BS 1363 plug, showing the fuse access from the underside of the plug. Right: a typical rewireable plug; the large central screw releases the cover, allowing access to the terminals and also the fuse BS 1363 is a which specifies the common single-phase that are used in the. Distinctive characteristics of the system are shutters on the line and neutral socket holes, and a fuse in the plug. It has been adopted in many former. BS 1363 was introduced in 1947 as one of the new standards for used for post-war reconstruction.

This plug corresponds to Type G in the IEC table. BS 1363 replaced the plug and socket (which are still found in old installations or in special applications such as remotely switched lighting). Other exceptions to the use of BS 1363 plugs and sockets include equipment requiring more than 13 A, low-power portable equipment (such as shavers and toothbrushes) and mains-operated clocks. BS 1363:1947 'Fused-Plugs and Shuttered Socket-Outlets' which resulted from the report 'Post-War Building Studies No. 11, Electrical Installations' In 1941, then the minister of Works and Planning, established committees to investigate problems likely to affect the post-war rebuilding of Britain. One of these, the Electrical Installations Committee, was charged with the study of all aspects of electrical installations in buildings. Amongst its members was Dame, President of the and an expert on safety in the home.

Convened in 1942, the committee reported in 1944, producing one of a set of that guided reconstruction. The plug and socket-outlet system defined in BS 1363 is a result of one of the report's recommendations. Britain had previously used a combination of 2 A, 5 A and 15 A round pin sockets. In an appendix to the main report (July 1944), the committee proposed that a completely new socket-outlet and fused plug should be adopted as the 'all-purpose' domestic standard. The main report listed 8 points to consider in deciding the design of the new standard. The first of these was stated as “To ensure the safety of young children it is of considerable importance that the contacts of the socket-outlet should be protected by shutters or other like means, or by the inherent design of the socket-outlet.” Others included flush fitting, no need for a switch, requirements for terminals, bottom entry for the cable, and contact design.

The appendix added 5 further 'points of technical detail' including requirements that plugs could not be inserted incorrectly, should be easy to withdraw, and should include a fuse. This requirement for a new system of plugs and sockets led to the publishing in 1947 of 'British Standard 1363:1947 Fused-Plugs and Shuttered Socket-Outlets'. One of the other recommendations in the report was the introduction of the system (often informally called a 'ring main'). In this arrangement a cable connected to a fuse, or circuit breaker, in the distribution board was wired in sequence to a number of sockets before being terminated back at the distribution board, thus forming a ring final circuit.

In the ring circuit, each socket-outlet was supplied with current by conductors on both sides of the 'loop.' This contrasts with the radial system (which is also used in the UK, often in the same installation) wherein a single cable runs out radially, like a spoke, from the distribution board to serve a number of sockets. Since the fuse or circuit breaker for a ring circuit has to be rated for the maximum current the ring could carry (30 A or 32 A for a breaker), additional protection is required at each socket-plug connection. Theoretically, such protection could have been designated either within the socket or within the plug. However, to ensure that this protection has a rating matched to the appliance flexible cord fitted to the plug, a fuse rated between 1 A and 13 A is incorporated into each plug. Wired connections may also be connected to the ring, and these are also required to include a suitably rated fuse. The ring circuit in the UK requires the use of BS 1363 plugs and sockets, but the BS 1363 system is not limited to use with ring circuits.

Chronology [ ]. An early MK plug to original version of standard.

Note the unsleeved Line & Neutral pins, and the inspection hole for the purpose of making the connection of an earth conductor visible with the cover in place (as required by BS 1363:1947 clause 15.) BS 1363 is periodically revised, and with supplements and amendments issued between major revisions. BS 1363:1984 and earlier versions dealt only with 13 A plugs and sockets. From 1989 onwards the standard was rearranged into five parts as follows: • Part 1: Rewirable and non-rewirable 13 A fused plugs • Part 2: 13 A Switched and unswitched socket-outlets • Part 3: Adaptors • Part 4: 13 A fused connection units: switched and unswitched • Part 5: 13 A fused conversion plugs The following chronology shows revisions, supplements and significant amendments. June 1947: BS 1363:1947 'Fused-Plugs and Shuttered Socket-Outlets' published. May 1950: BS 1363:1947 Amendment 3, title changed to 'Specification for two-pole and earthing-pin fused-plugs and shuttered socket-outlets for A.C. Circuits up to 250 Volts (not intended for use on D.C. January 1957: BS 1363:1947 Amendment 5, added clause permitting operation of shutters by simultaneous insertion of two or more pins (in addition to original method using only earth pin).

January 1957: BS 1363:1947 Supplement No. 1 added specification for surface mounted socket-outlets. 1957: Complementary standard published, BS 2814:1957 'Two-pole and earthing-pin flush-mounted 13-Amp switch socket-outlets for A.C. Circuits up to 250 Volts'. A separate standard specifying a switched version of the BS 1363 socket-outlet for use with BS 1363 plugs. December 1960: BS 1363:1947 Supplement No.

2, added specification for Resilient Plugs. December 1961: BS 2814:1957 Amendment 2, title simplified to '13 Ampere Switch Socket-Outlets'. 1962: BS 2814:1957 Supplement No. 1 added specification for surface mounted switch outlets. September 1967: BS 1363:1967 'Specification for 13A plugs, switched and unswitched socket-outlets and boxes' published.

This standard superseded both BS 1363:1947 and BS 2814:1957. Only 3 A and 13 A fuses are specified. Resilient Plugs are included.

August 1984: BS 1363:1984 'Specification for 13 A fused plugs switched and unswitched socket-outlets' published. This standard superseded BS 1363:1967. Changes include introduction of sleeved pins on Line and Neutral, metric dimensions replacing inches, specifications added for non-rewirable plugs and portable socket-outlets. The standard was aligned, where possible, with the proposed IEC standard for domestic plugs and socket-outlets.

February 1989: BS 1363-3:1989 '13 A plugs socket-outlets and adaptors - Part 3: Specification for adaptors' published. This new standard covers adaptors for use with BS 1363 socket-outlets and includes conversion adaptors (those which accept plugs of a different type), multiway adaptors (those which accept more than one plug, which may or may not be of a different type) and shaver adaptors.

All adaptors (except for those accepting not more than two BS 1363 plugs) require to be fused. All sockets, including those to other standards, must be shuttered.

1994: A Product Approval Specification, PAS 003:1994, 'Non-Rewirable 13 A Plugs with Plastic Socket Shutter Opening Pins' published. PAS 003 allowed for the design and approval of plugs without earthing intended for class II applications only. This was superseded by BS 1363-1:1995 but the PAS was not withdrawn until 23 July 2013. February 1995: BS 1363-1:1995 '13 A plugs socket-outlets adaptors and connection units - Part 1: Specification for rewirable and non-rewirable 13 A fused plugs' published.

This standard, together with BS 1363-2:1995, supersedes BS 1363:1984. The provisions of PAS 003 are incorporated, but the plastic pin is redesignated as an 'ISOD' September 1995: BS 1363-2:1995 '13 A plugs socket-outlets adaptors and connection units - Part 2: Specification for 13 A switched and unswitched socket-outlets' published. September 1995: BS 1363-3:1995 '13 A plugs socket-outlets adaptors and connection units - Part 3: Specification for adaptors' published. Supersedes BS 1363-3:1989 November 1995: BS 1363-4:1995 '13 A plugs socket-outlets adaptors and connection units - Part 4: Specification for 13 A fused connection units switched and unswitched' published. A new standard. August 2008: BS 1363-5:2008 '13 A plugs socket-outlets adaptors and connection units - Part 5: Specification for 13 A fused conversion plugs' published.

A new standard. May 2012: BS 1363-1:1995 +A4:2012 (Title unchanged) published. This amended standard allows switches to be incorporated into plugs, and introduced new overload tests amongst others. BS 1363-1:1995 remained current until 31 May 2015. May 2012: BS 1363-2:1995 +A4:2012 (Title unchanged) published. This amended standard adds a requirement that it shall not be possible to operate a shutter by the insertion of a two-pin Europlug, and introduced new temperature rise tests amongst others. BS 1363-2:1995 remained current until 31 May 2015.

May 2012: BS 1363-4:1995 +A4:2012 (Title unchanged) published. Minor changes to BS 1363-4:1995 which remained current until 31 May 2015.

November 2012: BS 1363-3:1995 +A4:2012 (Title unchanged) published. This amended standard adds a requirement that it shall not be possible to operate a shutter by the insertion of a two-pin Europlug, and added specifications for switched adaptors amongst others. BS 1363-3:1995 will remain current until 31 December 2015.

August 2016: BS 1363-1:2016 (Title unchanged) published. Added requirements for incorporated electronic components and for electric vehicle charging.

BS 1363-1:1995 +A4:2012 will remain current until 31 August 2019. August 2016: BS 1363-2:2016 (Title unchanged) published. Added requirements for incorporated electronic components and for electric vehicle charging. BS 1363-2:1995 +A4:2012 will remain current until 31 August 2019. August 2016: BS 1363-3:2016 (Title unchanged) published. Added requirements for incorporated electronic components.

BS 1363-3:1995 +A4:2012 will remain current until 31 August 2019. August 2016: BS 1363-4:2016 (Title unchanged) published. Minor changes only. BS 1363-4:1995 +A4:2012 will remain current until 31 August 2019. August 2016: BS 1363-5:2016 (Title unchanged) published. Minor changes only.

BS 1363-5:2008 will remain current until 31 August 2019. BS 1363-1 Rewirable and non-rewirable 13 A fused plugs [ ]. BS 1363 plug, with a plastic pin insulated shutter opening device (ISOD) and sleeved pins. A BS 1363 plug has two horizontal, rectangular pins for line and neutral, and above these pins, a larger, vertical pin for an earth connection. Note, both line and neutral carry current and are defined as live parts. The earth pin also serves to operate the basic shutter mechanism used in many sockets. Correct polarity is established by the position of the earth pin relative to the other two pins, ensuring that the line pin is connected to the correct terminal in the socket-outlet.

Moulded plugs for unearthed, appliances may instead have a non-conductive plastic pin (an Insulated Shutter Opening Device or ISOD) the same size and shape as an earth pin, to open the shutters. When looking at the plug pins with the earth uppermost the lower left pin is line, and the lower right is neutral. UK legislation requires that most domestic electrical goods sold must be provided with fitted plugs to BS 1363-1.

These are usually, but not necessarily, non-rewirable. Rewirable plugs for hand-wiring with a screwdriver are commonly available and must be provided with instructions. Nominal dimensions [ ] BS 1363-1 specifies the dimensions of plug pins and their disposition with respect to each other in precise, absolute terms. The line and neutral pins have a rectangular cross section 6.4 mm by 4.0 mm, 17.7 mm long and with centres 22.2 mm apart.

The protective-earth pin is a rectangular cross section 8.0 mm by 4.0 mm, 22.3 mm long and with a centre line 22.2 mm from the line/neutral pin centre line. The dimensions were originally specified in decimal inches with asymmetric tolerances and redefined as minimum and maximum metric dimensions in BS 1363:1984. Dimensions are chosen to provide safe clearance to live parts. The distance from any part of the line and neutral pins to the periphery of the plug base must be not less than 9.5 mm. This ensures that nothing can be inserted alongside a pin when the plug is in use, and helps keep fingers away from the pins.

The longer earth pin ensures that the earth path is connected before the live pins, and remains connected after the live pins are removed. The earth pin is too large to be inserted into the line or neutral sockets by mistake. Pin insulation [ ] Initially, BS 1363 did not require the line and neutral pins to have insulating sleeves. Plugs made to the recent revisions of the standard have insulated sleeves to prevent finger contact with pins, and also to stop metal objects (for example, fallen window blind slats) from becoming live if lodged between the wall and a partly pulled out plug. The length of the sleeves prevents any live contacts from being exposed while the plug is being inserted or removed.

An early method of sleeving the pins involving spring-loaded sleeves is described in the 1967 British Patent GB1067870. The method actually adopted is described in the 1972 British Patent GB1292991.

Plugs with such pins were available in the 1970s, a Southern Electricity/ safety pamphlet from 1978 encourages their use. Sleeved pins became required by the standard in 1984. BS 1362 fuses (for BS 1363 plugs) There are two common misconceptions about the purpose of the fuse in a BS 1363 plug, one is that it protects the appliance connected to the plug, and the other is that it protects against overloading. In fact the fuse is there to protect the flexible cord between the plug and the appliance under fault conditions (typical British can deliver more current than appliance flexible power cords can handle). BS 1363 plugs are required to carry a cartridge, which must conform to BS 1362.

Post-War Building Studies No. 11, Electrical Installations included the recommendation that Provision should be made in the plug for the accommodation of a cartridge type of fuse for 13 amps., and alternatively, for 3 amps.

Fuses of these ratings should be interchangeable and be readily identified. The original BS 1363:1947 specified fuse ratings of 3 A, 7 A and 13 A. The current version of the fuse standard, BS 1362:1973, allows any fuse rating up to 13 A, with 3 A (coloured red) and 13 A (coloured brown) as the preferred (but not mandated) values when used in a plug. All other ratings are to be coloured black. Plugs, when supplied separately from any appliance, should be available with either a 3 A or 13 A fuse fitted. The fuses are mechanically interchangeable; it is up to the end user or appliance manufacturer to install the appropriate rating. BS 1362 specifies sand-filled -bodied cylindrical fuses, 1' (25.4 mm) in length, with two metallic end caps of 1/4' (6.3 mm) diameter and roughly 1/5' long.

The standard specifies breaking time versus current characteristics only for 3 A or 13 A fuses. • For 3 A fuses: 0.02–80 s at 9 A. • Cable grip • Neutral terminal • Earth terminal • Line terminal • Fuse The plug sides are shaped to improve grip and make it easier to remove the plug from a socket-outlet. The plug is polarised, so that the fuse is in the line side of the supply. The flexible cord always enters the plug from the bottom, discouraging removal by tugging on the cable, which can damage the cable. Rewireable plugs must be designed so that they can be wired in a manner which prevents strain to the earth connection before the line and neutral connection in the event of failure of the cord anchorage. Ratings [ ] BS 1363 plugs and sockets are rated for use at a maximum of 250 V ac and 13 A, with the exception of non-rewirable plugs which have a current rating according to the type of cable connected to them and the fuse fitted.

The rating must be marked on the plug, and in the case of non-rewirable plugs the marking must be the value of the fuse fitted by the plug manufacturer in accordance with table 2 of the standard. Typical ratings for non-rewirable plugs are 3 A, 5 A, 10 A and 13 A. Counterfeits and non-standard plugs [ ] Plugs which do not meet BS 1363 often find their way into the UK. Some of these are legal in the country they are manufactured in, but do not meet BS 1363 - these can be brought into the UK by unsuspecting travellers, or people purchasing electrical goods online. They can also be purchased through many UK electrical component distributors.

There are also counterfeit plugs which appear to meet the standards (and are marked as such) but do not in fact comply. Legislation was introduced, with the last revision in 1994, to require plugs sold to meet the technical standard. Counterfeit products are regularly seized when found, to enforce the safety standards and to protect the approval marks and trademarks of imitated manufacturers. The pressure group PlugSafe reported in March 2014 that since August 2011 'thousands' of listings of products including illegal plugs had been removed from the UK websites and. The UK Electrical Safety Council expressed shock at the magnitude of the problem and published a video showing a plug exploding due to a counterfeit BS 1362 fuse. The also published information on the extent of the problem with on-line retailers, many advertising replacement cord sets, mobile device chargers, and travel adaptors fraudulently marked BS 1363, and mentioning the same sites. BS 1363 type electrical socket-outlet.

The closed shutters block entry of foreign objects BS 1363 sockets are commonly supplied with integral switches as a convenience, but switches are optional and did not form part of BS 1363 until 1967. Sockets are required to mate correctly with BS 1363 plugs (as opposed to the dimensions of the socket contacts being specified). This is checked by means of the use of various gauges which are specified in the standard; these gauges ensure that the socket contacts are correctly positioned and make effective and secure contact with the plug pins.

There is no provision for establishing the interchangeability with any other device having plug pins incorporated, but which is not covered by BS 1363 (for example a charger or socket cover) unless that device conforms precisely to the plug pin dimensions specified. The insertion of non-compliant plugs may damage sockets. The important socket dimensions which the standard does specify are: A minimum insertion of 9.6 mm from the face of the socket-outlet to the first point of contact with a live part, a minimum distance of 9.5 mm from the line and neutral apertures to the periphery of the socket face, and not to exceed dimensions for the apertures of 7.2 mm x 4.8 mm (line and neutral) and 8.8 mm x 4.8 mm (earth). When looking at the front of the socket with the earth aperture uppermost (as normally mounted) the lower left aperture is for the neutral contact, and the lower right is for the line contact. Shutters [ ] BS 1363 sockets must have shutters on the line and neutral contacts to prevent the insertion of a foreign object into the socket. Many sockets use the original method of shutters opened by the earth pin (or plastic ISOD), longer than the other pins and hence opening the shutters before the other pins engage, alone. Alternatively, shutters may be opened by simultaneous insertion of line and neutral pins.

Trivial Pursuit Unlimited Pc Ita Download Itunes. Some later designs require all three pins to be inserted simultaneously. The use of automatic shutters for protection dates back to at least 1927.

Other countries, for example the USA, are gradually requiring their sockets to be protected by shutters also. There is a specific requirement in the standard to ensure that Europlugs and other two-pin plugs may not be used with BS 1363 sockets It shall not be possible to operate a shutter by inserting a 2-pin plug into a 3-pin socket-outlet. However, many extension sockets will allow a plug to be inserted upside down, i.e. Only the earth pin, defeating the shutter mechanism. This method is sometimes used to allow a (with two small round pins and no earth pin) to be forced into the open line and neutral ports. The UK Electrical Safety Council has drawn attention to the fire risk associated with forcing Europlugs into BS 1363 sockets.

Socket covers [ ] In countries using other socket-outlet types, socket covers are sold to protect children from electrocution by inserting objects into otherwise unprotected sockets. Such covers are also sold in the UK, but the shutters of the BS 1363 socket-outlet make these unnecessary. The published an article on socket covers by Mark Coles, its Technical Regulations Manager, in its journal 'Wiring Matters'.

The article concludes that: 'Socket-outlets to BS 1363 are the safest in the world and have been since they were first designed in the 1940s. Socket protectors are not regulated for safety, therefore, using a non-standard system to protect a long established safe system is not sensible.' The UK government does not collect statistics of injury or accidents related to use of socket covers. A UK-based group called 'FatallyFlawed' notes that none of the available socket covers are made to BS 1363 dimensions and so can introduce hazards, either by damaging socket contacts or by allowing foreign objects to be inserted into the live openings. The FatallyFlawed website displays a statement from the socket-outlet manufacturer, 'MK goes to great lengths to ensure that all its BS 1363 plugs and sockets are safe. Inserting incorrectly dimensioned products into a socket-outlet can both damage the socket and reduce its safety'. As of 30 June 2016 the use of socket covers has been banned in all premises controlled by the (NHS) in the United Kingdom.

In October 2016 the UK Department for Education confirmed in a written answer to a parliamentary question that they have brought the Department of Health’s recent alert on the dangers associated with the use of electrical socket covers to the attention of early years providers in England. ‘Action for Children’ has published a notice, via the Foundation Years website, about the use of electrical socket covers in early years provision in England. This is available at: BEAMA (British Electrotechnical and Allied Manufacturers Association) published the following statement in June 2017: “BEAMA strongly advises against the use of socket-outlet ‘protective’ covers.”. Tripler (left) and doubler (right). The tripler has a red fuse carrier visible. Plug adaptors permit two or more plugs to share one socket-outlet, or allow the use of a plug of different type.

There are several common types, including double- and triple-socket blocks, shaver adaptors, and multi-socket strips. Adaptors which allow the use of non-BS 1363 plugs, or more than two BS 1363 plugs, must be fused. Appliances are designed not to draw more power than their plug is rated for; the use of such adaptors, and also multi-socketed extension leads, makes it possible for several appliances to be connected through a single outlet, with the potential to cause dangerous overloads.

Shaver adaptors [ ]. BS 1363-4 13 A fused connection units switched and unswitched [ ] Switched and unswitched connection units, without sockets, use BS 1362 fuses for connection of permanently wired appliances to a socket-outlet circuit. They are also used in other situations where a fuse or switch (or both) is required, such as when feeding lighting off a socket-outlet circuit, to protect spurs off a ring circuit with more than one socket-outlet, and sometimes to switch feeds to otherwise concealed sockets for kitchen appliances.

BS 1363-5 13 A fused conversion plugs [ ]. Conversion plug suitable for europlug, empty, europlug inserted and closed A conversion plug is a special type of plug suitable for the connection of non-BS 1363 type plugs (to a recognized standard) to BS 1363 sockets. An example would be appliances from mainland Europe which are fitted with moulded.

Similar converters are available for a variety of other plug types. Unlike a temporary travel adaptor, conversion plugs, when closed, resemble normal plugs, although larger and squarer. The non-BS 1363 plug is inserted into the contacts, and the hinged body of the conversion plug is closed and fixed shut to grip the plug. There must be an accessible fuse. Conversion plugs may be non-reusable (permanently closed) or reusable, in which case it must be impossible to open the conversion plug without using a tool.

The Plugs and Sockets, etc. (Safety) Regulations 1994 permit domestic appliances fitted with non-BS 1363 plugs to be supplied in the UK with conversion plugs fitted, but not with conversion plugs supplied for fitting by the consumer. BS 1363 variations [ ] Folding plugs [ ] Due to the size of the BS 1363 plug, attempts have been made to develop a compatible folding plug. As of July 2014 two folding plugs have been certified under specially developed ASTA Standards. SlimPlug which complies with ASTA AS153 and ThinPlug which complies with ASTA AS158.

SlimPlug is available only as part of a complete power lead terminating in an unpolarized (figure-of-eight) connector. In 2009 the ThinPlug received a ' award for product design, the first product, also a power lead terminating in an unpolarized (figure-of-eight) connector became available in 2011. • Folding plugs •.

ThinPlug with ISOD folded Variant pin configurations [ ] Several manufacturers have made deliberately incompatible variants for use where connection with standard plugs is not acceptable. Common uses include filtered supplies for computer equipment and cleaners' supplies in public buildings and areas (to prevent visitors plugging in unauthorised equipment). Examples are one design made by which has a T-shaped earth pin, and the Walsall Gauge 13 A plug, which has each pin rotated 90°, the latter being in use on parts of the for 110 V AC supply. And also in some British Rail offices for filtered computer supplies. • Variant plugs •. Walsall Gauge 13 A plug BS 8546 Travel adaptors compatible with UK plug and socket system [ ] BS 8546 applies to travel adaptors having at least one plug or socket-outlet portion compatible with BS 1363 plugs and socket-outlets. It was first published in April 2016 to provide a standard for travel adaptors suitable for the connection of a non-BS 1363 plug, or to a non-BS 1363 socket-outlet.

It provides for an overall rating of 250 V ac, minimum current rating of 5 A, and a maximum of 13 A. Adaptors with BS 1363 plug pins must incorporate a fuse. BS 8546 travel adaptors may also include USB charging ports. UK electric clock connector [ ]. British electric clock connector, 3-pin, made by MK. Showing the rear of the plug with its 2 A fuse. Fused plugs and sockets of various proprietary and non-interchangeable types are found in older public buildings in the UK, where they are used to feed AC electric wall clocks.

They are smaller than conventional sockets, commonly being made to fit junction boxes, and are often of very low profile. Early types were available fused in both poles, later types fused in the line only and provided an earth pin. Most are equipped with a retaining screw or clip to prevent accidental disconnection.

The prevalence of battery powered controlled wall clocks has meant that this connector is rarely seen in new installations for clock use. However, it has found use where a low profile fused connector is required and is still available.

A relatively common example of such a use is to supply power to an illuminated mirror that has limited clearance from the wall. Wylex 13 A Plug. Note offset line pin (top of photograph). Wylex Plug [ ] George H.

Of Manchester first introduced plugs with a hollow round earth pin between rectangular current-carrying pins in 1926 under the Wylex brand name, this was prior to the first British Standard for earthed plugs. The Wylex plugs were initially made in three ratings, 5 A, 10 A and 15 A and were unpolarized (the current carrying pins were on the same centre line as the earth pin). In 1933 an asymmetric polarized version was introduced, with line pin slightly offset from the centre line.

In 1934 the dual plug system was introduced with the socket rated at 15 A and three sizes of plug, fused 2 A and 5 A plugs and a 15 A plug. The 15 A 'dual plug' incorporated a socket with narrower apertures than a standard Wylex 15 A socket, that accepted only the narrow rectangular pins of the lower-rated plugs. The introduction of a 13 A fused plug, rated as 3 kW., enabled Scholes to propose their system as a possible solution for the new standard competing with the Dorman & Smith round pin solution, but it was not selected and the completely new BS 1363 design prevailed. Wylex sockets were used in and public sector buildings and, for a short time in private housing.

They were particularly popular in the area although they were installed throughout England, mainly in schools, university accommodation, and government laboratories. In some London schools built in the 1960s they were used as low-voltage AC sockets, typically 12 V, 5 A from a transformer serving one or more laboratories, for microscope lamps etc. Wylex plugs and sockets continued to be manufactured for several years after BS 1363 sockets became standard, and were commonly used by banks and in computer rooms during the 1960s and 1970s for or 'clean' filtered mains supplies. Dorman & Smith (D&S) [ ].

3 D&S Sockets mounted on a panel Made by Dorman & Smith Ltd. (using patents applied for in 1943) the plugs and sockets were rated at 13 A and were one of the competing types for use on. They were never popular in private houses but were widely deployed in houses and.

The also used them. Some local authorities continued to use them in new installations until the late 1950s. Many D&S sockets were still in use until the early 1980s, although the difficulty in obtaining plugs for them after around 1970 often forced their users to replace them with BS 1363 sockets.

The D&S plug suffered from a serious design fault: the line pin was a fuse which screwed into the plug body and tended to come unscrewed on its own in use. A fuse that worked loose could end up protruding from the socket, electrically live and posing a shock hazard, when the plug was removed. International usage of BS types [ ] Standards derived from BS 546 [ ] Indian IS 1293 [ ] Indian standard IS 1293:2005 Plugs and Socket-Outlets of Rated Voltage up to and including 250 Volts and Rated Current up to and including 16 Amperes includes versions of the 5 A and 15 A BS 546 connectors, but they are rated at 6 A and 16 A respectively.

Some 6 A 3 pin sockets also have two extra holes above the line and neutral holes to allow a 5 A 2-pin plug to be connected. Malaysian Standard MS 1577 [ ] MS 1577:2003 15 A plugs and socket-outlets for domestic and similar purposes Russian GOST 7396 [ ] The 2 A, 5 A, and 15 A, connectors of BS 546 are duplicated by Group B1 of the standard. Singapore Standard SS 472 [ ] SS 472:1999 15 A plugs and switched socket-outlets for domestic and similar purposes South African SANS 164 [ ]. Main article: The South African standard SANS 164 Plug and socket-outlet systems for household and similar purposes for use in South Africa defines a number of derivatives of BS 546. A household plug and socket is defined in SANS 164-1, and is essentially a modernised version of the BS 546 15 A (the essential differences are that pins can be hollowed to reduce the amount of metal used, the dimensions are metricated, and it is rated 16 A). SANS 164-3 defines a 6 A plug and socket based on the BS 546 5 A. The South African Wiring Code now defines the plug and socket system defined in SANS 164-2 () as the preferred standard, and it is expected that SANS 164-1 and SANS 164-3 devices will be phased out by around 2035.

SANS 164-4 defines three variants of the 16 A plug and socket intended for specialist (known as 'dedicated') applications. The variants use a flattened earth pin, each at a different specified rotational position. This arrangement ensures that the dedicated plugs can all plug into an ordinary ('non-dedicated') socket, but that the various dedicated plug and socket combinations are not interchangeable (nor can a non-dedicated plug be inserted into a dedicated socket).

The dedicated versions have specific colours assigned to them, depending on the rotational position of the flattened portion. These are black (-53°), red (0°), and blue (+53°). The red (0°) version is by far the most common, and is widely used on computer and telecommunication equipment (although this is not required in the standard). In this application the 'dedicated' socket refers to one that is not connected to a, which is otherwise mandated for all normal power sockets. International usage of Type D [ ] The IEC World Plugs lists Type D as being used in the following locations: Bangladesh, Bhutan, Botswana, Chad, Congo (Democratic Rep.

Of), Dominica, French Guiana, Ghana, Guadeloupe, Guyana, Hong Kong, India, Iraq, Jordan, Lebanon, Libya, Macau, Madagascar, Maldives, Martinique, Monaco, Myanmar, Namibia, Nepal, Niger, Nigeria, Pakistan, Qatar, Saint Kitts and Nevis, Senegal, Sierra Leone, South Africa, Sri Lanka, Sudan, Tanzania, United Arab Emirates, Yemen, Zambia, Zimbabwe. International usage of Type M [ ] This plug is often used for and. The IEC World Plugs lists Type M as being used in the following locations: Bhutan, Botswana, India, Israel, Lesotho, Macau, Malaysia, Mozambique, Namibia, Nepal, Pakistan, Singapore, South Africa, Sri Lanka, Swaziland. Standards derived from BS 1363 [ ] Irish I.S.

401 [ ] Irish Standard 401:1997 Safety requirements for rewirable and non-rewirable 13 A fused plugs for normal and rough use having insulating sleeves on live and neutral pins is the equivalent of BS 1363 in Ireland. The use of this standard is enforced by legislation which requires that most domestic electrical goods sold in Ireland be fitted with an I.S. 401 plug. Malaysian Standard MS 589 [ ] MS 589 parts 1,2,3 and 4 correspond to BS 1363-1, BS 1363-2, BS 1363-3 and BS 1363-4 Russian GOST 7396 [ ] Group B2 of the standard describes BS 1363 plugs and sockets.

• BS 546: 'Specification. Two-pole and earthing-pin plugs, socket-outlets and socket-outlet adaptors' (1950) •, Assembly Automation and Product Design, Second Edition, Geoffrey Boothroyd, CRC Press, 2005, p.315 (retrieved 20 December 2013 from Google Books) •, Physics for AQA, Patrick Fullick, Heinemann, 2001, p.16 (retrieved 1 March 2013 from Google Books) •, Trevor Linsley, Routledge, 2008, p.37 (retrieved 2 March 2013 from Google Books) •, IEC/TR 60083 Ed.

Adobe Flash Player is required to view this feature. If you are using an operating system that does not support Flash, we are working to bring you alternative formats. Original Article Apixaban versus Warfarin in Patients with Atrial Fibrillation Christopher B.

Granger, M.D., John H. Alexander, M.D., M.H.S., John J.V. McMurray, M.D., Renato D. Lopes, M.D., Ph.D., Elaine M. Hylek, M.D., M.P.H., Michael Hanna, M.D., Hussein R.

Al-Khalidi, Ph.D., Jack Ansell, M.D., Dan Atar, M.D., Alvaro Avezum, M.D., Ph.D., M. Cecilia Bahit, M.D., Rafael Diaz, M.D., J. Donald Easton, M.D., Justin A.

Ezekowitz, M.B., B.Ch., Greg Flaker, M.D., David Garcia, M.D., Margarida Geraldes, Ph.D., Bernard J. Gersh, M.D., Sergey Golitsyn, M.D., Ph.D., Shinya Goto, M.D., Antonio G. Hermosillo, M.D., Stefan H. Hohnloser, M.D., John Horowitz, M.D., Puneet Mohan, M.D., Ph.D., Petr Jansky, M.D., Basil S. Lewis, M.D., Jose Luis Lopez-Sendon, M.D., Prem Pais, M.D., Alexander Parkhomenko, M.D., Freek W.A.

Verheugt, M.D., Ph.D., Jun Zhu, M.D., and Lars Wallentin, M.D., Ph.D., for the ARISTOTLE Committees and Investigators N Engl J Med 2011; 365:981-992 DOI: 10.1056/NEJMoa1107039 open through September 21, 2011. Methods In this randomized, double-blind trial, we compared apixaban (at a dose of 5 mg twice daily) with warfarin (target international normalized ratio, 2.0 to 3.0) in 18,201 patients with atrial fibrillation and at least one additional risk factor for stroke. The primary outcome was ischemic or hemorrhagic stroke or systemic embolism. The trial was designed to test for noninferiority, with key secondary objectives of testing for superiority with respect to the primary outcome and to the rates of major bleeding and death from any cause. Results The median duration of follow-up was 1.8 years.

The rate of the primary outcome was 1.27% per year in the apixaban group, as compared with 1.60% per year in the warfarin group (hazard ratio with apixaban, 0.79; 95% confidence interval [CI], 0.66 to 0.95; P. Figure 2 Relative Risks of the Primary Efficacy and Safety Outcomes, According to Major Prespecified Subgroups. Prespecified subgroups not included in the figure were subgroups according to race, ethnic group, body-mass index, number of risk factors, age of 75 years or more, and use or nonuse of clopidogrel at the time of randomization, as well as subgroups of women according to age group. Heart failure was defined as symptomatic heart failure or a left ventricular ejection fraction of 40% or less. The CHADS 2 score, an index of the risk of stroke in patients with atrial fibrillation, ranges from 1 to 6, with higher scores indicating a greater risk of stroke.

TIA denotes transient ischemic attack. Patients with atrial fibrillation are at increased risk for stroke. Warfarin and other vitamin K antagonists are highly effective treatments, reducing the risk of stroke by about two thirds, but their use is limited by a narrow therapeutic range, drug and food interactions, required monitoring, and risk of bleeding. A randomized trial has confirmed the effectiveness of warfarin in the current era. Two new oral anticoagulants have recently been shown to be equivalent or superior to warfarin in preventing stroke or systemic embolism. Apixaban is a direct oral factor Xa inhibitor with rapid absorption, a 12-hour half-life, and 25% renal excretion. In patients with atrial fibrillation who were not candidates for vitamin K antagonists, apixaban, as compared with aspirin, reduced the rate of stroke or systemic embolism by 55% without increasing the risk of major bleeding.

In the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial, we compared apixaban with warfarin for the prevention of stroke or systemic embolism in patients with atrial fibrillation and at least one additional risk factor for stroke. Study Oversight The trial was designed and led by a steering committee that included academic investigators and representatives of the sponsors (Bristol-Myers Squibb and Pfizer). Approval by the appropriate ethics committees was obtained at all sites. All patients provided written informed consent. The primary analyses were performed both at Bristol-Myers Squibb and at the Duke Clinical Research Institute. All the authors participated in the design of the trial and the planning of the analyses. The first author wrote the first draft of the manuscript, and all the authors participated in subsequent revisions (with no writing assistance other than copy editing) and approved the final version of the manuscript.

The trial and statistical analysis plan are available with the full text of this article at NEJM.org. All the authors assume responsibility for the accuracy and completeness of the data and the analyses and for the fidelity of the study to the protocol. Trial Design The trial design has been reported previously. With the use of a double-blind, double-dummy design, we randomly assigned patients to treatment with apixaban or dose-adjusted warfarin. The primary objective was to determine whether apixaban was noninferior to warfarin in reducing the rate of stroke (ischemic or hemorrhagic) or systemic embolism among patients with atrial fibrillation and at least one other risk factor for stroke.

The primary safety outcome was major bleeding, according to the criteria of the International Society on Thrombosis and Haemostasis (ISTH). Key secondary objectives were to determine whether apixaban was superior to warfarin with respect to the primary outcome and to the rates of major bleeding and death from any cause. To control the overall type I error, prespecified hierarchical sequential testing was performed first on the primary outcome for noninferiority, then on the primary outcome for superiority, then on major bleeding, and finally on death from any cause. Study Population Eligible patients had atrial fibrillation or flutter at enrollment or two or more episodes of atrial fibrillation or flutter, as documented by electrocardiography, at least 2 weeks apart in the 12 months before enrollment. In addition, at least one of the following risk factors for stroke was required: an age of at least 75 years; previous stroke, transient ischemic attack, or systemic embolism; symptomatic heart failure within the previous 3 months or left ventricular ejection fraction of no more than 40%; diabetes mellitus; or hypertension requiring pharmacologic treatment. Key exclusion criteria were atrial fibrillation due to a reversible cause, moderate or severe mitral stenosis, conditions other than atrial fibrillation that required anticoagulation (e.g., a prosthetic heart valve), stroke within the previous 7 days, a need for aspirin at a dose of >165 mg a day or for both aspirin and clopidogrel, and severe renal insufficiency (serum creatinine level of >2.5 mg per deciliter [221 μmol per liter] or calculated creatinine clearance of. Randomization and Study Drugs Randomization was stratified according to whether patients had received warfarin previously and according to clinical site.

Apixaban or matching placebo was administered twice daily, with apixaban given in 5-mg doses; 2.5-mg doses were used in a subset of patients with two or more of the following criteria: an age of at least 80 years, a body weight of no more than 60 kg, or a serum creatinine level of 1.5 mg per deciliter (133 μmol per liter) or more. Warfarin (or matching placebo) was provided as 2-mg tablets and was adjusted to achieve a target international normalized ratio (INR) of 2.0 to 3.0. Patients who were receiving a vitamin K antagonist before randomization were instructed to discontinue the drug 3 days before randomization, and the study drug was initiated when the INR was less than 2.0. INRs were monitored with the use of a blinded, encrypted, point-of-care INR device. An algorithm was provided to guide the adjustment of the warfarin dose. The time that patients' INRs were within the therapeutic range was calculated by the Rosendaal method. A program was implemented to improve the quality of INR control through education and feedback at the site and country levels.

An algorithm was provided to manage temporary discontinuations of the study drug around the time of interventional procedures while maintaining concealment of the group assignments. At the end of the trial, when patients discontinued the study drug, guidance was provided in making the transition to open-label warfarin while maintaining concealment of the treatment assignments and ensuring appropriate anticoagulation.

In addition to monthly study visits focusing on control of the INR, visits every 3 months included an assessment of clinical outcomes and adverse events. For each patient who was lost to follow-up or who withdrew consent, attempts were made to determine vital status at the end of the trial. Study Outcomes The primary efficacy outcome was stroke or systemic embolism. Stroke was defined as a focal neurologic deficit, from a nontraumatic cause, lasting at least 24 hours and was categorized as ischemic (with or without hemorrhagic transformation), hemorrhagic, or of uncertain type (in the case of patients who did not undergo brain imaging or in whom an autopsy was not performed). The key secondary efficacy outcome was death from any cause.

The rate of myocardial infarction was also assessed as a secondary efficacy outcome. The primary safety outcome was major bleeding, which was defined, according to the ISTH criteria, as clinically overt bleeding accompanied by a decrease in the hemoglobin level of at least 2 g per deciliter or transfusion of at least 2 units of packed red cells, occurring at a critical site, or resulting in death. The secondary safety outcome was a composite of major bleeding and clinically relevant nonmajor bleeding, which was defined as clinically overt bleeding that did not satisfy the criteria for major bleeding and that led to hospital admission, physician-guided medical or surgical treatment, or a change in antithrombotic therapy. Other safety outcomes included any bleeding, other adverse events, and liver-function abnormalities. The primary and secondary efficacy and safety outcomes were adjudicated on the basis of prespecified criteria by a clinical-events committee whose members were not aware of study-group assignments. For details, see the, available at NEJM.org. Statistical Analysis The primary noninferiority hypothesis required that apixaban preserve at least 50% of the relative reduction in the risk of stroke or systemic embolism associated with warfarin (62%) in six previous, major randomized, controlled trials.

This hypothesis provided a lower 95% confidence interval of 1.88 for the relative risk with placebo as compared with warfarin, and one half of this value was 1.44 (or 1.38 on a log scale). We estimated that with the occurrence of the primary outcome in 448 patients, the study would have 90% power to ensure that the upper boundary of the 99% confidence interval for the relative risk would be less than 1.44 and that the upper boundary of the 95% confidence interval for the relative risk would be less than 1.38, on the assumption that apixaban and warfarin had identical effects.

On the basis of the overall event rate during the trial, we planned to recruit 18,000 patients in order to reach this number of events with approximately 2 years of follow-up. An independent data and safety monitoring committee reviewed the accumulating trial data, with one prespecified interim analysis for efficacy. The primary and key secondary analyses were performed with the use of the Cox proportional-hazards model, with previous warfarin status and geographic region (North America, South America, Europe, or Asian Pacific) used as strata in the model. The primary and secondary efficacy analyses included all patients who underwent randomization (intention-to-treat population) and included all events from the time of randomization until the cutoff date for efficacy outcomes (predefined as January 30, 2011). The analyses of bleeding events included all patients who received at least one dose of a study drug and included all events from the time the first dose of a study drug was received until 2 days after the last dose was received. In a modified intention-to-treat sensitivity analysis, we analyzed bleeding events that occurred in patients who received at least one dose of a study drug and included all events from the time of randomization until January 30, 2011. All reported P values for noninferiority are one-sided, and all reported P values for superiority are two-sided.

All statistical analyses were performed with the use of SAS software, version 9.0 (SAS Institute). Patients and Follow-up From December 19, 2006, through April 2, 2010, we recruited 18,201 patients at 1034 clinical sites in 39 countries. A total of 9120 were assigned to the apixaban group and 9081 to the warfarin group. The two groups were well balanced with respect to baseline characteristics ( Table 1 Baseline Characteristics of the Patients. The median age was 70 years; 35.3% of the patients were women, and the mean CHADS 2 score was 2.1. (The CHADS 2 score, an index of the risk of stroke in patients with atrial fibrillation, ranges from 1 to 6, with higher scores indicating a greater risk of stroke.) Approximately 57% of the patients had previously received a vitamin K antagonist, and 19% had had a previous stroke, transient ischemic attack, or systemic embolism. Data on vital status at the end of the trial were missing for 380 patients (2.1%).

The absence of data on vital status was due to withdrawal of consent in the case of 92 patients in the apixaban group (1.0%) and 107 patients in the warfarin group (1.2%) and was due to loss to follow-up in the case of 35 patients in the apixaban group (0.4%) and 34 in the warfarin group (0.4%). Study Drugs A reduced dose of apixaban (2.5 mg twice daily) or placebo was administered in 428 patients in the apixaban group (4.7%) and 403 in the warfarin group (4.4%). Fewer patients in the apixaban group than in the warfarin group discontinued a study drug before the end of the study: 25.3% of the patients in the apixaban group, with 3.6% of the discontinuations due to death, versus 27.5% of patients in the warfarin group, with 3.8% due to death (P=0.001). Patients in the warfarin group had an INR in the therapeutic range (2.0 to 3.0) for a median of 66.0% of the time and a mean of 62.2% of the time, after the exclusion of INR values during the first 7 days after randomization and during study-drug interruptions. Primary Outcome The primary outcome of stroke or systemic embolism occurred in 212 patients in the apixaban group (1.27% per year) as compared with 265 patients in the warfarin group (1.60% per year) (hazard ratio in the apixaban group, 0.79; 95% confidence interval [CI], 0.66 to 0.95; P. Key Secondary and Other Efficacy Outcomes The rate of death from any cause was lower in the apixaban group than in the warfarin group (3.52% per year vs.

3.94% per year; hazard ratio, 0.89; 95% CI, 0.80 to 0.99; P=0.047). The rate of death from cardiovascular causes (including death from hemorrhagic stroke) was 1.80% per year in the apixaban group and 2.02% per year in the warfarin group (hazard ratio, 0.89; 95% CI, 0.76 to 1.04), and the rate of death from noncardiovascular causes (including fatal bleeding other than that from hemorrhagic stroke) was 1.14% per year in the apixaban group and 1.22% per year in the warfarin group (hazard ratio, 0.93; 95% CI, 0.77 to 1.13). The rate of myocardial infarction was lower in the apixaban group than in the warfarin group, but the difference was not significant ( ). Bleeding Major bleeding, as defined according to ISTH criteria, occurred in 327 patients in the apixaban group (2.13% per year), as compared with 462 patients in the warfarin group (3.09% per year) (hazard ratio, 0.69; 95% CI, 0.60 to 0.80; P. Subgroups The reduction in the primary outcome with apixaban was consistent across all major subgroups ( Figure 2 Relative Risks of the Primary Efficacy and Safety Outcomes, According to Major Prespecified Subgroups.

Prespecified subgroups not included in the figure were subgroups according to race, ethnic group, body-mass index, number of risk factors, age of 75 years or more, and use or nonuse of clopidogrel at the time of randomization, as well as subgroups of women according to age group. Heart failure was defined as symptomatic heart failure or a left ventricular ejection fraction of 40% or less.

The CHADS 2 score, an index of the risk of stroke in patients with atrial fibrillation, ranges from 1 to 6, with higher scores indicating a greater risk of stroke. TIA denotes transient ischemic attack. ), and statistical tests for interaction were not significant (P>0.10) for all of the 21 predefined subgroups. With respect to the outcome of major bleeding, the only baseline characteristics for which the interaction was significant were diabetes status and renal function, with a greater reduction in bleeding among patients who did not have diabetes (P=0.003 for interaction) and among patients with moderate or severe renal impairment (P=0.03 for interaction). Discussion In patients with atrial fibrillation and at least one additional risk factor for stroke, the use of apixaban, as compared with warfarin, significantly reduced the risk of stroke or systemic embolism by 21%, major bleeding by 31%, and death by 11%. For every 1000 patients treated for 1.8 years, apixaban, as compared with warfarin, prevented a stroke in 6 patients, major bleeding in 15 patients, and death in 8 patients.

The predominant effect on stroke prevention was on hemorrhagic stroke, with prevention of a hemorrhagic stroke in 4 patients per 1000 and prevention of an ischemic or unknown type of stroke in 2 patients per 1000. The results were consistent in subgroups according to geographic region, status with respect to previous warfarin exposure, age, sex, level of renal impairment, and risk factors for stroke, as well as in other predefined subgroups. Apixaban had an acceptable side-effect profile, with no unexpected side effects, and the rate of discontinuation of the study drug was lower in the apixaban group than in the warfarin group. Warfarin is highly effective in preventing stroke in patients with atrial fibrillation but is associated with a variable response, has drug and food interactions, requires regular monitoring for dose adjustment, and carries a risk of bleeding (including intracranial hemorrhage). In part because of these limitations, only about half of patients who would benefit from warfarin therapy actually receive the drug. The alternative treatment regimen with apixaban (at a dose of 5 mg twice daily), which does not require anticoagulation monitoring, not only is more effective than warfarin for stroke prevention but also accomplishes this goal at a substantially lower risk of bleeding and with lower rates of discontinuation.

These findings are supported by the results of the Apixaban Versus Acetylsalicylic Acid [ASA] to Prevent Stroke in Atrial Fibrillation Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment trial (AVERROES; ClinicalTrials.gov number, NCT00496769), in which the same apixaban regimen, as compared with low-dose aspirin, was shown to substantially reduce the risk of stroke without any difference in the rates of major bleeding and with lower rates of discontinuation. Although major bleeding was less common with apixaban, at a dose of 5 mg twice daily, than with warfarin in patients with atrial fibrillation, the use of the same dose of apixaban, as compared with placebo, resulted in more bleeding in patients with acute coronary syndromes who were receiving both aspirin and clopidogrel.

The significant reduction in mortality observed in our study was consistent with trends toward lower rates of death among patients receiving apixaban than among those receiving aspirin in the AVERROES trial. Two alternative oral anticoagulants, the direct thrombin inhibitor dabigatran and the factor Xa inhibitor rivaroxaban, have recently been shown in randomized clinical trials to be at least as effective as warfarin in preventing stroke. Each of these agents, like apixaban, has the major advantage of convenience, since there is no need for anticoagulation monitoring. In the Randomized Evaluation of Long-Term Anticoagulation Therapy trial (RE-LY, NCT00262600) the oral direct thrombin inhibitor dabigatran administered in two doses per day was compared with open-label warfarin. The 150-mg dose of dabigatran administered twice daily, as compared with warfarin, was shown to reduce the rate of stroke, including ischemic or unspecified stroke, with a similar overall rate of bleeding, although the rate of gastrointestinal bleeding was increased.

The 110-mg dose administered twice daily was associated with a rate of stroke that was similar to that with warfarin but with a lower rate of major bleeding. Both doses resulted in lower rates of intracranial hemorrhage. In our study, apixaban at a dose of 5 mg twice daily (with the recommendation to use a reduced dose in patients with a predicted higher drug exposure) appears to combine the advantages of each of the two doses of dabigatran, with both a greater overall reduction in the rate of stroke and a lower rate of bleeding than the rates with warfarin. As compared with warfarin, apixaban is also associated with a reduction in the rate of gastrointestinal bleeding and with consistently lower bleeding rates across age groups and all other major subgroups. Fewer patients receiving apixaban had a myocardial infarction than those receiving either warfarin (in our study) or aspirin (in the AVERROES trial). Rivaroxaban, the second new alternative, was shown to be noninferior to warfarin for the prevention of stroke and systemic embolism in the intention-to-treat analysis in the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF, NCT00403767). The rates of intracranial hemorrhage and fatal bleeding were lower with rivaroxaban than with warfarin, but there was no advantage with respect to other major bleeding.

The differences between our findings and those of other trials comparing novel anticoagulants with warfarin may be related to differences in the doses of drugs, the pharmacokinetic and pharmacodynamic properties of the drugs, patient populations, or other features of the clinical-trial design. The lower risk of hemorrhagic stroke associated with all three novel anticoagulants suggests that there is a specific risk associated with warfarin, possibly related to its inhibition of multiple coagulation factors or interaction between warfarin and tissue factor VIIa complexes in the brain. In conclusion, in patients with atrial fibrillation, apixaban was superior to warfarin in preventing stroke or systemic embolism, caused less bleeding, and resulted in lower mortality. Supported by Bristol-Myers Squibb and Pfizer. Granger reports receiving grants from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, the Medtronic Foundation, Merck, Sanofi-Aventis, Astellas, and the Medicines Company, consulting fees from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Hoffmann-La Roche, Novartis, Otsuka Pharmaceutical, Sanofi-Aventis, and the Medicines Company, and support from the Medtronic Foundation and Merck for travel, accommodations, or meeting expenses; Dr.

Alexander, receiving grants from Merck/Schering-Plough and Regado Biosciences and consulting fees from Merck/Schering-Plough, AstraZeneca, Boehringer Ingelheim, Ortho-McNeil-Janssen, PolyMedix, Regado Biosciences, and Bayer; Dr. Lopes, receiving grants from Bristol-Myers Squibb, AstraZeneca, Boehringer Ingelheim, and Daiichi Sankyo and consulting fees from Bristol-Myers Squibb; Dr. Hylek, receiving consulting fees from Johnson & Johnson, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Merck, Pfizer, and Ortho-McNeil-Janssen and lecture fees from Boehringer Ingelheim; Dr. Hanna, being an employee of Bristol-Myers Squibb and receiving stock as part of his compensation; Dr. Ansell, being a member of Bristol-Myers Squibb's data and safety monitoring boards, receiving consulting fees from Ortho-McNeil-Janssen, Daiichi Sankyo, Boehringer Ingelheim, and Bristol-Myers Squibb, and receiving payments from Daiichi Sankyo for developing educational presentations; Dr. Atar, receiving consulting fees or honoraria from Bristol-Myers Squibb; Dr.

Avezum, receiving consulting fees from Boehringer Ingelheim and GlaxoSmithKline; Dr. Bahit, receiving consulting fees or honoraria and other research support from Bristol-Myers Squibb; Dr. Diaz, receiving consulting fees or honoraria and other research support from Bristol-Myers Squibb; Dr. Ezekowitz, receiving research support, honoraria, and payments for continuing medical education events from AstraZeneca, Amgen, Abbott, Servier, Johnson & Johnson, Pfizer, and Bristol-Myers Squibb; Dr.

Flaker, receiving consulting fees from Boehringer Ingelheim and Sanofi-Aventis and grants from Boehringer Ingelheim and Sanofi-Aventis; Dr. Garcia, receiving consulting fees from Bristol-Myers Squibb, Pfizer, Boehringer Ingelheim, and Daiichi Sankyo and payments from Boehringer Ingelheim for developing educational presentations; Dr. Geraldes, being an employee of Bristol-Myers Squibb and receiving stock or stock options annually; Dr. Gersh, receiving consulting fees from Ortho-McNeil-Janssen, Amorcyte, Abbott Laboratories, GE Healthcare, St. Jude Medical, Medispec, Merck, and Boston Scientific; Dr. Goto, being a board member of Bristol-Myers Squibb and Sanofi-Aventis, receiving grants from Boehringer Ingelheim, Otuska, Eisai, Sanofi-Aventis, and Daiichi Sankyo, consulting fees from Eisai, lecture fees from Eisai, Otsuka, Daiichi Sankyo, Sanofi-Aventis, Bayer, Novartis, AstraZeneca, Asteras, Pfizer, Medtronics-Japan, Tanabe-Mitsubishi, Takeda, Mochida, and MSD, and payments from Bayer and Sanofi-Aventis for developing educational presentations; Dr. Hermosillo, receiving consulting fees or honoraria from Bristol-Myers Squibb; Dr.

Hohnloser, receiving consulting fees from Sanofi-Aventis, St. Jude Medical, Boehringer Ingelheim, Cardiome, and Medtronic Vascular and lecture fees from Sanofi-Aventis, Bristol-Myers Squibb, Pfizer, Boehringer Ingelheim, and St. Jude Medical; Dr. Horowitz, receiving research support from Bristol-Myers Squibb; Dr. Mohan, being an employee of Bristol-Myers Squibb and receiving performance-based stock or stock options annually; Dr. Lewis, being an advisory board member for Bayer Healthcare; Dr. Lopez-Sendon, receiving grants from Bristol-Myers Squibb, Boehringer Ingelheim, and Bayer and consulting fees from Boehringer Ingelheim; Dr.

Parkhomenko, receiving consulting fees and grants from Borshchiagovsky Chemical-Pharmaceutical Plant; Dr. Verheugt, receiving lecture fees from Bayer and AstraZeneca and consulting fees from Bayer and Daiichi Sankyo; and Dr. Wallentin, receiving grants from Bristol-Myers Squibb, Pfizer, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Schering-Plough, and Merck, consulting fees from Regado Biotechnologies, Portola, CSL Behring, Athera Biotechnologies, Boehringer Ingelheim, AstraZeneca, and GlaxoSmithKline, and lecture fees from Bristol-Myers Squibb, Pfizer, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Schering-Plough, and Merck. Provided by the authors are available with the full text of this article at NEJM.org. No other potential conflict of interest relevant to this article was reported.

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