Deep sedation protocol during atrial fibrillation ablation using a novel variable-loop biphasic pulsed field ablation...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Pulsed field ablation (PFA) is an emerging nonthermal ablation technique for atrial fibrillation (AF).
• The inspIRE study demonstrated the safety and efficacy of a biphasic PFA system for paroxysmal AF treatment.
• General anesthesia is commonly used for PFA, but carries inherent risks.

Purpose of the Study:

• To evaluate the safety and efficacy of a deep sedation protocol for PFA procedures.
• To assess patient comfort and satisfaction during PFA under sedation.
• To determine if deep sedation is a suitable alternative to general anesthesia for PFA.

Main Methods:

• A total of 29 patients undergoing PFA for AF were analyzed.
• A specific deep sedation protocol was administered and monitored.
• Patient sedation levels were assessed using the Richmond Agitation-Sedation Scale (RASS) and Visual Analogue Scale (VAS).
• Patient State Index (PSI) and Likert Scale Questionnaire (LSQ) were used for monitoring and satisfaction assessment.

Main Results:

• No procedural complications were observed in any patient.
• Adequate oxygen saturation was maintained throughout all procedures.
• The deep sedation protocol successfully achieved target RASS scores in 93% of patients and VAS scores in 83% of patients.
• Most patients reported positive satisfaction with the intraoperative analgesia-sedation.

Conclusions:

• The reported deep sedation protocol is a safe and effective alternative to general anesthesia for PFA procedures.
• This sedation strategy facilitates PFA procedures using a biphasic pulse system with a variable loop circular catheter.
• Deep sedation enhances patient comfort and satisfaction during PFA for AF treatment.