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

Münkler, Paula; Attanasio, Philipp; Parwani, Abdul Shokor; Huemer, Martin; Boldt, Leif‐Hendrik; Haverkamp, Wilhelm; Wutzler, Alexander

doi:10.1111/pace.13063

Cited by 11 publications

(10 citation statements)

References 22 publications

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“…Moreover, these patients could also benefit on patient satisfaction and possible reduction of hospitalization time. The last one has been demonstrated in a series of patients undergoing cardiac surgery where the use of hypnosis in the pre and post-operative period was able to reduce hospitalization time [[13], [14], [15]].…”

Section: Discussionmentioning

confidence: 99%

Hypnotic communication for periprocedural analgesia during transcatheter ablation of atrial fibrillation

Scaglione

Battaglia

Donna

et al. 2019

IJC Heart & Vasculature

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Introduction Hypnosis is a therapeutic strategy for pain control. We aimed at investigating the use of this technique in a large population undergoing atrial fibrillation (AF) ablation. Methods 70 consecutive AF patients referred for transcatheter ablation, underwent hypnotic communication for periprocedural analgesia (Group A), were compared with 70 patients undergoing conventional analgesia (Group B). Procedural data, anxiety, perceived pain, perceived procedural duration and the dosages of administered analgesic drugs were compared using validated score scales. Results Hypnotic communication (Group A) resulted in a significant procedural-related anxiety reduction (Pre procedural 4.7 ± 2.9 Vs Intra Procedural 0.8 ± 1.2, P < 0.001) and perceived procedural duration (Real length 108 ± 33 min Vs Perceived Length 77 ± 39 min, P < 0.001). Group A patients reported a painless procedure in 78% (Pain scale ≤2). Regarding analgesic drug, Group A used only Fentanyl and Paracetamol. The Fentanyl dosage was similar in Group A and B (mean 0.142 Vs 0.146 mg, P = 0.65) while higher Paracetamol dosage was reported in Group A (mean 853 Vs 337 mg, P < 0.001). Group B also used Midazolam (mean 1.8 mg), Propofol (mean 43.8 mg) and narcosis was required in 2 patients. Total radiofrequency (RF) delivered time did not differ between the two groups (mean 28.9 Vs 27.6 min, P = 0.623) as well as mean RF power (mean 35.3 Vs 35.5 W, P = 0.424). No complications occurred. Conclusion Hypnotic communication during AF ablation was related to a significant reduction of intra-procedural anxiety, perceived pain, procedural analgesic drugs dosage and perceived procedural duration without affecting total RF delivered time and procedural safety.

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Section: Discussionmentioning

confidence: 99%

Hypnotic communication for periprocedural analgesia during transcatheter ablation of atrial fibrillation

Scaglione

Battaglia

Donna

et al. 2019

IJC Heart & Vasculature

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“…Our results expand the options for anesthesia strategy during PSVT ablation beyond minimal sedation, and we expect it to lead to greater patient satisfaction. 2 patients with ectopic AT, the tachycardia terminated after propofol infusion and could not be induced by ISP. 19 Theoretically, if the mechanism of AT is abnormal automaticity or triggered activity, its inducibility can be decreased by deep sedation that reduces sympathetic nerve activity.…”

Section: Need Of Deep Sedation For Psvt Ablationmentioning

confidence: 90%

Outcomes of deep sedation for catheter ablation of paroxysmal supraventricular tachycardia, with adaptive servo ventilation

Hayashi

Mizukami

Kuroda

et al. 2020

Journal of Arrhythmia

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“…This disadvantage is further supported by Narui et al, 22 in which patients with mild sedation endured pain and uncomfortable conditions during procedure. A survey by Münkler et al 30 also demonstrated a high patient satisfaction with deep sedation, with 83% of patients considering it to be 'good' or 'very good'.…”

Section: Safety and Concerns Regarding Ga/deep Sedation And Consciousmentioning

confidence: 97%

Anaesthesia use in catheter ablation for atrial fibrillation: a systematic review and meta-analysis of observational studies

Sang

Chan

et al. 2019

Heart Asia

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ObjectivesThis meta-analysis and systematic review seeks to compare both characteristic parameters and procedural outcomes of atrial fibrillation (AF) catheter ablation in patients under general anaesthesia (GA)/deep sedation and mild/moderate sedation.BackgroundCatheter ablation has become a widely applied intervention for treating symptomatic AF and arrhythmias that are refractory to medical therapy. It can be conducted through from mild sedation to GA.MethodsPubMed and Embase were searched up to July 2018 for randomised controlled trials, cohort and observational studies that assessed the outcomes of catheter ablation under GA/deep sedation or mild/moderate sedation. Nine studies were included in this meta-analysis after screening with the inclusion and exclusion criteria. Heterogeneity between studies and publication bias was evaluated by I2 index and Egger’s regression, respectively.ResultsOur meta-analysis found catheter AF ablation with GA/deep sedation to be associated with reduced risk of recurrence (RR: 0.79, 95% CI 0.56 to 1.13, p=0.20) and complications (RR: 0.95, 95% CI 0.64 to 1.42, p=0.82), though statistically insignificant. In terms of procedural parameters, there was no significant difference between the two groups for both procedural time (SMD: −0.13, 95% CI −0.90 to 0.63, p=0.74) and fluoroscopy time (SMD: −0.41, 95% CI −1.40 to 0.58, p=0.41). Univariate meta-regression did not reveal any covariates as a moderating factor for complication and recurrence risk.ConclusionApart from an increased likelihood of procedural success, ablation by GA/deep sedation was found to be non-significantly different from the mild/moderate sedation approach in both procedural parameters and outcome measures.

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

Cited by 11 publications

References 22 publications

Hypnotic communication for periprocedural analgesia during transcatheter ablation of atrial fibrillation

Hypnotic communication for periprocedural analgesia during transcatheter ablation of atrial fibrillation

Outcomes of deep sedation for catheter ablation of paroxysmal supraventricular tachycardia, with adaptive servo ventilation

Anaesthesia use in catheter ablation for atrial fibrillation: a systematic review and meta-analysis of observational studies

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