Investigating Deep Sedation With Intravenous Ketamine in Spontaneous Respiration During Pulsed-Field Ablation

Area of Science:

• Cardiology
• Anesthesiology
• Medical Devices

Background:

• Atrial fibrillation (AF) is a common arrhythmia requiring treatment.
• Pulsed-field ablation (PFA) is an emerging therapy for AF.
• Deep sedation is often necessary for AF ablation procedures.

Purpose of the Study:

• To evaluate a deep sedation protocol using ketamine during PFA for AF.
• To assess the safety and efficacy of this sedation strategy.
• To determine patient and operator satisfaction with the protocol.

Main Methods:

• An observational, prospective, nonrandomized study was conducted at a single center.
• 117 consecutive patients undergoing PFA for AF received deep sedation with intravenous ketamine.
• The protocol involved fentanyl, midazolam, and ketamine, with monitoring of sedation levels and pain.

Main Results:

• Pulmonary vein isolation was achieved in all patients via PFA.
• The mean sedation time was approximately 55 minutes, with most patients sedated for under an hour.
• High patient and operator satisfaction (98.2%) and low pain scores (≤3) were reported.
• No major procedure or anesthesia-related complications occurred.

Conclusions:

• A standardized deep sedation protocol with ketamine is safe and effective for PFA in AF patients.
• The protocol ensures optimal patient and operator satisfaction.
• This approach utilizes drugs with rapid onset and offset for efficient anesthesia management.