Deep sedation during catheter ablation for atrial fibrillation in elderly patients

Wutzler, Alexander; Loehr, Lena; Huemer, Martin; Parwani, Abdul Shokor; Steinhagen‐Thiessen, Elisabeth; Boldt, Leif‐Hendrik; Haverkamp, Wilhelm

doi:10.1007/s10840-013-9817-3

Cited by 22 publications

(10 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although some studies have reported hypotension as a side effect of deep sedation during AF ablation, it is not prolonged and usually controllable [23]. In the present study, the sedation level was appropriate, and no patients required inotropic drugs for severe hemodynamic instability.…”

Section: Discussionmentioning

confidence: 54%

Airway support using a pediatric intubation tube in adult patients with atrial fibrillation: A simple and unique method to prevent heart movement during catheter ablation under continuous deep sedation

Takigawa

Takahashi

Kuwahara

et al. 2017

Journal of Arrhythmia

View full text Add to dashboard Cite

BackgroundThe present study aimed to elucidate the safety and effectiveness of a noble and unique airway management technique in which a pediatric intubation tube is used in adult patients with atrial fibrillation (AF) undergoing catheter ablation (CA) under continuous deep sedation.MethodsIn total, 246 consecutive patients with AF (mean age, 65±10 years; 60 women) underwent CA under dexmedetomidine-based continuous deep sedation. A 4-mm pediatric intubation tube guided by a 10-French intratracheal suction tube was inserted smoothly, and the tip of the tube was located at the base of the epiglottis. The maximum shifting distance of the heart (MSDH) was measured with the 3D mapping system (Ensite NavX system) before and after inserting the pediatric intubation tube.ResultsAt baseline, the MSDH of patients under continuous deep sedation was 23±14 mm. The pediatric intubation tube reduced the MSDH to 13±6 mm (mean reduction from baseline, 38.4±21.7%; P<0.0001). In contrast, oxygen saturation was significantly increased from 89±8% to 95±3% (P<0.0001). The mean distance between the nostril and base of the epiglottis was 16.6±0.5 mm. Major periprocedural complications occurred in 9 (3.6%) patients including 3 (1.2%) cardiac tamponade and 6 (2.4%) phrenic nerve injury cases. Larger MSDH (odds ratio, 1.13; 95% confidence interval, 1.04–1.25; P=0.007) was a significant predictor of major periprocedural complications. No major airway complications occurred, except in 3 patients (1.2%) who had minor nasal bleeding.ConclusionThis unique airway management technique using a pediatric intubation tube for CA procedures performed in adult patients with AF under continuous deep sedation was easy, safe, and effective.

show abstract

Section: Discussionmentioning

confidence: 54%

Airway support using a pediatric intubation tube in adult patients with atrial fibrillation: A simple and unique method to prevent heart movement during catheter ablation under continuous deep sedation

Takigawa

Takahashi

Kuwahara

et al. 2017

Journal of Arrhythmia

View full text Add to dashboard Cite

show abstract

“…Guiot et al demonstrated that age >75 years is an independent predictor of late cerebrovascular events . Wutzler et al reported that respiratory infections and renal failure after ablation are high in the elderly . However, several trials investigating the complication rates in elderly patients undergoing ablation have shown favorable outcomes as compared to those in younger patients .…”

Section: Discussionmentioning

confidence: 99%

Comparing between second‐generation cryoballoon vs open‐irrigated radiofrequency ablation in elderly patients: Acute and long‐term outcomes

Chen

Zhong

Jin

et al. 2020

Clinical Cardiology

View full text Add to dashboard Cite

Background: Limited comparative data are available regarding catheter ablation (CA) of atrial fibrillation (AF) using second-generation cryoballoon (CB-2) vs radiofrequency (RF) ablation in elderly patients (>75-year-old).Hypothesis: CB-2 ablation may demonstrate different outcomes compared with that using RF ablation for elderly patients with AF.Method: Elderly patients with symptomatic drug-refractory AF were included in the study. Pulmonary vein isolation was performed in all patients.Results: A total of 324 elderly patients were included (RF: 176, CB-2:148) from September 2016 to April 2019. The CB-2 was associated with shorter procedure time and left atrial dwell time (112.9 ± 11.1 vs 135.1 ± 9.9 minutes, P < .001; 53.7 ± 8.9 vs 65.1.9 ± 9.0 minutes, P < .001), but marked fluoroscopy utilization (22.1 ± 3.3 vs 18.5 ± 3.6 minutes, P < .001). Complications occurred in 3.3% (CB-2) and 6.2% (RF) of patients with no significant different (P = .307). The length of stay after ablation was shorter, but the costs were higher in the CB-2 group (1.94 vs 2.53 days, P < .001 and 91 132.6 ± 3723.5 vs 81 149.4 ± 6824.1 CNY, P < .001) compared to the RF group. Additionally, the rate of early recurrence of atrial arrhythmia was lower in the CB-2 group (14.2 vs 23.3%, P = .047), but the long-term success rate was similar between two groups.Conclusions: CB-2 is associated with shorter procedure time, left atrial dwell time, and length of stay after ablation, but its costs and fluoroscopy time are greater than the RF group. Moreover, the rate of complications and long-term success are similar between the two groups. K E Y W O R D S atrial fibrillation, costs and long-term outcomes, elderly patients, radiofrequency ablation, second-generation cryoballoon ablation

show abstract

“…Studies examining sedation in cardiac EP have focused on safety and feasibility, assessing complications associated with anesthesia and ablation‐related complications . Deep sedation under propofol has been shown to be safe even in elderly patients . Procedural sedation with ketamine is also reported in the field of EP .…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12][13] Deep sedation under propofol has been shown to be safe [12][13][14] even in elderly patients. 15 Procedural sedation with ketamine is also reported in the field of EP. 16 However, very few data are available on patients' satisfaction with sedation for catheter ablation, whereas after gastroenterologic endoscopic procedures under deep sedation patients expressed a high level of satisfaction.…”

Section: Discussionmentioning

confidence: 99%

High Patient Satisfaction with Deep Sedation for Catheter Ablation of Cardiac Arrhythmia

Münkler

Attanasio

Parwani

et al. 2017

Pacing Clinical Electrophis

Self Cite

View full text Add to dashboard Cite

show abstract

Deep sedation during catheter ablation for atrial fibrillation in elderly patients

Cited by 22 publications

References 25 publications

Airway support using a pediatric intubation tube in adult patients with atrial fibrillation: A simple and unique method to prevent heart movement during catheter ablation under continuous deep sedation

Airway support using a pediatric intubation tube in adult patients with atrial fibrillation: A simple and unique method to prevent heart movement during catheter ablation under continuous deep sedation

Comparing between second‐generation cryoballoon vs open‐irrigated radiofrequency ablation in elderly patients: Acute and long‐term outcomes

High Patient Satisfaction with Deep Sedation for Catheter Ablation of Cardiac Arrhythmia

Contact Info

Product

Resources

About