Romil Patel, Riya Sam, Lavisha Singh, Westby Fisher, Mark Metzl, Jose Nazari, Alex Ro, Hany Demo, Jeremiah Wasserlauf
{"title":"Feasibility of deep sedation for catheter ablation of atrial fibrillation using pulsed field ablation.","authors":"Romil Patel, Riya Sam, Lavisha Singh, Westby Fisher, Mark Metzl, Jose Nazari, Alex Ro, Hany Demo, Jeremiah Wasserlauf","doi":"10.1007/s10840-025-02050-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Pulsed field ablation (PFA) is a non-thermal energy source for catheter ablation associated with shorter procedure time, less risk of esophageal injury, and less dependence on absolute catheter stability compared with radiofrequency ablation. Limited data are available on performing the procedure with deep sedation (DS) as an alternative to general anesthesia (GA) utilizing endotracheal intubation.</p><p><strong>Methods: </strong>Patients who underwent PFA using DS between March and August 2024 were retrospectively included. DS was administered by anesthesia staff, consisting of propofol, dexmedetomidine, fentanyl, and midazolam, at the discretion of the practitioner. The primary endpoint was the rate of airway complications or requirement for conversion to GA. Secondary endpoints were the rate of acute procedural success, total time in the EP lab, procedure time, and non-procedure time.</p><p><strong>Results: </strong>A total of 100 patients (mean age 71.9 ± 11.6 years, BMI 30.1 ± 7.1, 51% females) were included in the analysis. There were no instances of airway complications or conversion from DS to GA. There was a 100% rate of acute isolation of pulmonary veins. The average total time in the lab was 149.7 ± 44.7 min, consisting of a mean procedure time of 98.3 ± 40.5 min and a non-procedure time of 51.4 ± 12.2 min.</p><p><strong>Conclusions: </strong>In this study conducted at a single health system, DS for PFA was feasible and associated with no instances of airway complications nor conversion to GA. The findings may not apply to patients with moderate or severe obstructive sleep apnea or other pulmonary diseases.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Interventional Cardiac Electrophysiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10840-025-02050-7","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Pulsed field ablation (PFA) is a non-thermal energy source for catheter ablation associated with shorter procedure time, less risk of esophageal injury, and less dependence on absolute catheter stability compared with radiofrequency ablation. Limited data are available on performing the procedure with deep sedation (DS) as an alternative to general anesthesia (GA) utilizing endotracheal intubation.
Methods: Patients who underwent PFA using DS between March and August 2024 were retrospectively included. DS was administered by anesthesia staff, consisting of propofol, dexmedetomidine, fentanyl, and midazolam, at the discretion of the practitioner. The primary endpoint was the rate of airway complications or requirement for conversion to GA. Secondary endpoints were the rate of acute procedural success, total time in the EP lab, procedure time, and non-procedure time.
Results: A total of 100 patients (mean age 71.9 ± 11.6 years, BMI 30.1 ± 7.1, 51% females) were included in the analysis. There were no instances of airway complications or conversion from DS to GA. There was a 100% rate of acute isolation of pulmonary veins. The average total time in the lab was 149.7 ± 44.7 min, consisting of a mean procedure time of 98.3 ± 40.5 min and a non-procedure time of 51.4 ± 12.2 min.
Conclusions: In this study conducted at a single health system, DS for PFA was feasible and associated with no instances of airway complications nor conversion to GA. The findings may not apply to patients with moderate or severe obstructive sleep apnea or other pulmonary diseases.
期刊介绍：
The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.
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