General anesthesia reduces the prevalence of pulmonary vein reconnection during repeat ablation when compared with conscious sedation: Results from a randomized study

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

“…This study reported that use of general anesthesia increased the single procedure success rate, lowered the prevalence of PV reconnection among those who needed a redo procedure, and shortened fluoroscopy time and procedure time. 633 Another nonrandomized clinical trial reported improved efficacy of AF ablation with use of jet ventilation. 634 A survey of the writing group members performing AF ablations found that 73% use general anesthesia, 13% use deep sedation with an anesthesiologist, and 14% use moderate conscious sedation with an electrophysiology nurse.…”

“…This study reported that use of general anesthesia increased the single procedure success rate, lowered the prevalence of PV reconnection among those who needed a redo procedure, and shortened fluoroscopy time and procedure time. 633 General anesthesia is of particular importance for patients at risk of airway obstruction, those with a history of sleep apnea, and those at increased risk of pulmonary edema. General anesthesia may also be employed electively in healthy patients in order to improve patient tolerance of the procedure.…”

Isoproterenol infusion increases level of consciousness during catheter ablation of atrial fibrillation

“…Regarding clinical implications, during electrophysiologic studies and catheter ablation procedures in which isoproterenol infusion is utilized routinely, BIS appears to be an important tool for the optimization of TIVA [3,[12][13][14][15][16]. Di Biase et al demonstrated that patient movement may adversely affect ablation procedure results [12].…”

“…Di Biase et al demonstrated that patient movement may adversely affect ablation procedure results [12]. However, paralysis with neuromuscular blockade may place patients at risk of undetected phrenic nerve and esophageal injury from collateral ablation damage [12].…”

Real-Time Contact Force Measurement

“…Spatial catheter stability and CF during RF ablation can be improved with various adjunctive measures, such as general anesthesia 34 or high frequency jet ventilation 35 (to control by guest on May 10, 2018…”