Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec;20(4):468-473.
doi: 10.5114/aic.2024.144976. Epub 2024 Nov 12.

Conscious sedation with the combination of midazolam and fentanyl is effective and safe for cryoablation of paroxysmal atrial fibrillation

Hazar Harbalıoğlu  1 , Halil Nacar  2 , Hatice Simsek Ulku  2 , Dilek Destegul  2 , Dilek Ucak  2 , Derya Ceviz  3 , Hasan Koca  1 , Hüseyin Ali Öztürk  4 , Mevlut Koc  1
Affiliations

Conscious sedation with the combination of midazolam and fentanyl is effective and safe for cryoablation of paroxysmal atrial fibrillation

Hazar Harbalıoğlu et al. Postepy Kardiol Interwencyjnej. 2024 Dec.

Abstract

Introduction: Studies on anesthesia for cryoablation, one of the methods used in the treatment of atrial fibrillation (AF), and its effect on perioperative parameters are limited.

Aim: To compare the effects of conscious sedation with a combination of midazolam-fentanyl and unconscious sedation with propofol-midazolam on the success of the procedure.

Material and methods: 242 patients who underwent AF cryoablation for the first time were included. The ASA score and baseline SaO2 before the procedure, and the minimum SaO2, systolic and diastolic blood pressure change and the Richmond Agitation Sedation Scale (RASS) score during the procedure were obtained. Study data were divided into 2 groups - conscious sedation and unconscious sedation - and compared.

Results: Demographic, laboratory and echocardiographic findings did not differ significantly between the two groups (p > 0.05). When the hemodynamic parameters of the periprocedural AF ablation process and the effects of anesthesia were examined according to the anesthesia groups of the patients, minimum SaO2 during the procedure was significantly higher in the group that underwent conscious sedation (93.6 ±2.21% vs. 92.4 ±1.96% and p < 0.01). RASS score, blood pressure changes were found to be significantly lower in the conscious sedation group (p < 0.01 for each). However, procedural time, fluoroscopy time, ASA score, non-invasive mechanical ventilation (NIMV) requirement, basal SaO2, procedure success and frequency of AF recurrence were not significantly different between prolonged recovery groups (p > 0.05 for each).

Conclusions: In our study, it was found that the conscious sedation preference during AF cryoablation could be applied with similar success and recurrence compared to unconscious sedation with propofol and midazolam.

Keywords: atrial fibrillation; conscious sedation and unconscious sedation; cryoablation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Similar articles

See all similar articles

References

    1. Calkins H, Hindricks G, Cappato R, et al. . 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm 2017; 14: e275-444. - PMC - PubMed
    1. Li KHC, Sang T, Chan C, et al. . Anaesthesia use in catheter ablation for atrial fibrillation: a systematic review and meta-analysis of observational studies. Heart Asia 2019; 11: e011155. - PMC - PubMed
    1. Wutzler A, Loehr L, Huemer M, et al. . Deep sedation during catheter ablation for atrial fibrillation in elderly patients. J Interv Card Electrophysiol 2013; 38: 115-21. - PubMed
    1. Wang Z, Jia L, Shi T, et al. . General anesthesia is not superior to sedation in clinical outcome and cost-effectiveness for ablation of persistent atrial fibrillation. Clin Cardiol 2021; 44: 218-21. - PMC - PubMed
    1. Kottkamp H, Hindricks G, Eitel C, et al. . Deep sedation for catheter ablation of atrial fibrillation: a prospective study in 650 consecutive patients. J Cardiovasc Electrophysiol 2011; 22: 1339-43. - PubMed

LinkOut - more resources