Worldwide sedation strategies for atrial fibrillation ablation: current status and evolution over the last decade
Por:
Garcia, R, Waldmann, V, Vanduynhoven, P, Nesti, M, Figueiredo, MJD, Narayanan, K, Conte, G, Guerra, JM, Boveda, S, Duncker, D
Publicada:
1 dic 2021
Ahead of Print:
1 jul 2021
Resumen:
Catheter ablation for atrial fibrillation (AF) has become one of the most common procedures in the electrophysiotogy lab with rapidly increasing volumes. Peri-procedural anaesthesia for AF ablation varies between centres, from general anaesthesia to deep or conscious sedation. The aim of this survey was to assess current sedation practices for AF ablation worldwide and its evolution over the last decade. Centres regularly performing AF ablation responded to an online survey. A total of 297 centres participated in the survey. Overall, the median (interquartile range) number of AF ablation procedures increased from 91 (43-200) to 200 (74-350) per year (P< 0.001) between 2010 and 2019. The proportion of cryoablation also increased from 17.0% to 33.2% (P< 0.001). In 2019, the most used sedation technique was general anaesthesia (40.5%), followed by conscious sedation (32.0%) and deep sedation (27.5%). Between 2010 and 2019, the proportion of procedures performed under general anaesthesia (+4.4%; P= 0.02) and deep sedation (+4.8%; P < 0.01) increased, whereas the use of conscious sedation decreased (-9.2%; P <0.001). The most commonly used hypnotic drugs were propofol and midazolam, whereas the most commonly used opioid drugs were remifentanyl and fentanyl. This worldwide survey shows that the number of AF ablation procedures has more than doubled over the last decade and general anaesthesia remains most commonly used. Studies comparing outcomes between different sedation strategies are needed to guide optimal decision-making.
Filiaciones:
Garcia, R:
Univ Hosp Poitiers, Dept Cardiol, 2 Rue Miletrie, F-86021 Poitiers, France
Univ Poitiers, Fac Med & Pharm, F-86021 Poitiers, France
Waldmann, V:
Hop Europeen Georges Pompidou, Dept Cardiol, 20 Rue Leblanc, F-75015 Paris, France
Vanduynhoven, P:
Arrhythmia Clin Algemeen Stedelijk Ziekenhuis Aal, Dept Cardiol, Aalst, Belgium
Nesti, M:
San Donato Hosp, Dept Cardiol & Neurol, Arezzo, Italy
Figueiredo, MJD:
Univ Campinas Hosp, Dept Internal Med, Electrophysiol Unit, Prof Cardiol, Campinas, SP, Brazil
Narayanan, K:
Medicover Hosp, Dept Cardiol, Hyderabad, India
Conte, G:
Ente Osped Cantonale, Ticino Inst, Dept Cardiol, Lugano, Switzerland
Guerra, JM:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Arrhythmia Unit, CIBERCV, Barcelona, Spain
Boveda, S:
Clin Pasteur, Cardiol Heart Rhythm Management Dept, 45 Ave Lombez, F-31076 Toulouse, France
Vrije Univ Brussel VUB, Univ Ziekenhuis, Laarbeeklaan 101, B-1090 Jette Brussels, Belgium
Duncker, D:
Hannover Med Sch, Hannover Heart Rhythm Ctr, Dept Cardiol & Angiol, Hannover, Germany
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