Premium
Moderate Sedation Reduces Lab Time Compared to General Anesthesia during Cryoballoon Ablation for AF Without Compromising Safety or Long‐Term Efficacy
Author(s) -
WASSERLAUF JEREMIAH,
KNIGHT BRADLEY P.,
LI ZHI,
ANDREI ADINCRISTIAN,
ARORA RISHI,
CHICOS ALEXANDRU B.,
GOLDBERGER JEFFREY J.,
KIM SUSAN S.,
LIN ALBERT C.,
VERMA NISHANT,
BOHN MARTHA M.,
PASSMAN ROD S.
Publication year - 2016
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12961
Subject(s) - medicine , anesthesia , interquartile range , midazolam , atrial fibrillation , sedation , pulmonary vein , tachycardia , atrial tachycardia , ablation , cryoablation , propofol , catheter ablation , cardiology , surgery
Background Cryoballoon ablation (CBA) for paroxysmal atrial fibrillation (pAF) can be performed under general anesthesia (GA) or moderate sedation (MS). Our objective was to compare the effectiveness, safety, procedure duration, and time spent in the electrophysiology (EP) laboratory for CBA performed under GA and MS. Methods Patients undergoing a first CBA for pAF were identified. Patients received either GA administered by an anesthesiologist or MS with midazolam and fentanyl administered by EP laboratory staff. Total time in laboratory (sum of procedure and nonprocedure time); fluoroscopy time; freedom from documented AF, atrial flutter, and atrial tachycardia (FFAF); acute pulmonary vein isolation (PVI) rate; and 30‐day complication rate were assessed. Results A total of 55 patients received GA and 119 patients received MS. PVI success rate was 100% in GA and 98.1% in MS (P = 0.04). Total laboratory time was longer for GA (280.4 ± 54.1 minutes vs 245.5 ± 54.7 minutes; P < 0.001), related to longer nonprocedure time (92.2 ± 28.8 minutes GA vs 71.0 ± 30.0 minutes MS; P < 0.001), but not procedure time (188.3 ± 49.3 minutes GA vs 174.5 ± 50.2 minutes MS; P = 0.09). FFAF was not significantly different over a median follow‐up duration of 0.9 (interquartile range 0.4–1.9) years (61.8% GA vs 63.0% MS; log‐rank P = 0.90). There was no significant difference in complication rate. Conclusion Compared to GA, MS during CBA for pAF was independently associated with shorter total EP laboratory time without compromising FFAF or complication rates.