Pulsed-field versus cryoballoon ablation for atrial fibrillation-Impact of energy source on sedation and analgesia requirement
© 2023 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals LLC..
INTRODUCTION: Pulsed field ablation (PFA) represents a novel, nonthermal energy modality that can be applied for single-shot pulmonary vein isolation (PVI) in atrial fibrillation (AF). Comparative data with regard to deep sedation to established single-shot modalities such as cryoballoon (CB) ablation are scarce. The aim of this study was to compare a deep sedation protocol in patients receiving PVI with either PFA or CB.
METHODS: Prospective, consecutive AF patients undergoing PVI with a pentaspline PFA catheter were compared to a retrospective CB-PVI cohort of the same timeframe. Study endpoints were the requirements of analgesics, cardiorespiratory stability, and sedation-associated complications.
RESULTS: A total of 100 PVI patients were included (PFA n = 50, CB n = 50, mean age 66 ± 10.6, 61% male patients, 65% paroxysmal AF). Requirement of propofol, midazolam, and sufentanyl was significantly higher in the PFA group compared to CB [propofol 0.14 ± 0.04 mg/kg/min in PFA vs. 0.11 ± 0.04 mg/kg/min in CB (p = .001); midazolam 0.00086 ± 0.0004 mg/kg/min in PFA vs. 0.0006295 ± 0.0003 mg/kg/min in CB (p = .002) and sufentanyl 0.0013 ± 0.0007 µg/kg/min in PFA vs. 0.0008 ± 0.0004 µg/kg/min in CB (p < .0001)]. Sedation-associated complications did not differ between both groups (PFA n = 1/50 mild aspiration pneumonia, CB n = 0/50, p > .99). Nonsedation-associated complications (PFA: n = 2/50, 4%, CB: n = 1/50, 2%, p > .99) and procedure times (PFA 75 ± 31, CB 84 ± 32 min, p = .18) did not differ between groups.
CONCLUSIONS: PFA is associated with higher sedation and especially analgesia requirements. However, the safety of deep sedation does not differ to CB ablation.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
|---|---|
| Enthalten in: |
Journal of cardiovascular electrophysiology - 35(2024), 1 vom: 27. Jan., Seite 162-170 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Wahedi, Rahin [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Analgesia |
|---|
| Anmerkungen: |
Date Completed 10.01.2024 Date Revised 10.01.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/jce.16141 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM365007536 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM365007536 | ||
| 003 | DE-627 | ||
| 005 | 20240114233427.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/jce.16141 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1255.xml |
| 035 | |a (DE-627)NLM365007536 | ||
| 035 | |a (NLM)38009545 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Wahedi, Rahin |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pulsed-field versus cryoballoon ablation for atrial fibrillation-Impact of energy source on sedation and analgesia requirement |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 10.01.2024 | ||
| 500 | |a Date Revised 10.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals LLC. | ||
| 520 | |a INTRODUCTION: Pulsed field ablation (PFA) represents a novel, nonthermal energy modality that can be applied for single-shot pulmonary vein isolation (PVI) in atrial fibrillation (AF). Comparative data with regard to deep sedation to established single-shot modalities such as cryoballoon (CB) ablation are scarce. The aim of this study was to compare a deep sedation protocol in patients receiving PVI with either PFA or CB | ||
| 520 | |a METHODS: Prospective, consecutive AF patients undergoing PVI with a pentaspline PFA catheter were compared to a retrospective CB-PVI cohort of the same timeframe. Study endpoints were the requirements of analgesics, cardiorespiratory stability, and sedation-associated complications | ||
| 520 | |a RESULTS: A total of 100 PVI patients were included (PFA n = 50, CB n = 50, mean age 66 ± 10.6, 61% male patients, 65% paroxysmal AF). Requirement of propofol, midazolam, and sufentanyl was significantly higher in the PFA group compared to CB [propofol 0.14 ± 0.04 mg/kg/min in PFA vs. 0.11 ± 0.04 mg/kg/min in CB (p = .001); midazolam 0.00086 ± 0.0004 mg/kg/min in PFA vs. 0.0006295 ± 0.0003 mg/kg/min in CB (p = .002) and sufentanyl 0.0013 ± 0.0007 µg/kg/min in PFA vs. 0.0008 ± 0.0004 µg/kg/min in CB (p < .0001)]. Sedation-associated complications did not differ between both groups (PFA n = 1/50 mild aspiration pneumonia, CB n = 0/50, p > .99). Nonsedation-associated complications (PFA: n = 2/50, 4%, CB: n = 1/50, 2%, p > .99) and procedure times (PFA 75 ± 31, CB 84 ± 32 min, p = .18) did not differ between groups | ||
| 520 | |a CONCLUSIONS: PFA is associated with higher sedation and especially analgesia requirements. However, the safety of deep sedation does not differ to CB ablation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a analgesia | |
| 650 | 4 | |a atrial fibrillation | |
| 650 | 4 | |a cryoballoon | |
| 650 | 4 | |a pulmonary vein isolation | |
| 650 | 4 | |a pulsed field ablation | |
| 650 | 4 | |a sedation | |
| 650 | 7 | |a Propofol |2 NLM | |
| 650 | 7 | |a YI7VU623SF |2 NLM | |
| 650 | 7 | |a Midazolam |2 NLM | |
| 650 | 7 | |a R60L0SM5BC |2 NLM | |
| 700 | 1 | |a Willems, Stephan |e verfasserin |4 aut | |
| 700 | 1 | |a Feldhege, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Jularic, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Hartmann, Jens |e verfasserin |4 aut | |
| 700 | 1 | |a Anwar, Omar |e verfasserin |4 aut | |
| 700 | 1 | |a Dickow, Jannis |e verfasserin |4 aut | |
| 700 | 1 | |a Harloff, Tim |e verfasserin |4 aut | |
| 700 | 1 | |a Gessler, Nele |e verfasserin |4 aut | |
| 700 | 1 | |a Gunawardene, Melanie A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of cardiovascular electrophysiology |d 1996 |g 35(2024), 1 vom: 27. Jan., Seite 162-170 |w (DE-627)NLM074905481 |x 1540-8167 |7 nnns |
| 773 | 1 | 8 | |g volume:35 |g year:2024 |g number:1 |g day:27 |g month:01 |g pages:162-170 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/jce.16141 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 35 |j 2024 |e 1 |b 27 |c 01 |h 162-170 | ||