Impact of General Anesthesia on Catheter Stability During Pulmonary Vein Isolation of Atrial Fibrillation

The application of radiofrequency ablation for pulmonary vein isolation (PVI) under general anesthesia (GA) has shown a lower recurrence rate of atrial fibrillation (AF) compared with deep sedation (DS). However, the effect of the different anesthesia methodology on catheter stability remains unclear.

We enrolled 32 patients (16 in each group) who underwent PVI using radiofrequency ablation with the CARTO system. The contact force (CF) at each ablation point and catheter tip movement distance were analyzed using VISITAG^TM. A total of 1,863 points (GA: 964 points, DS: 899 points) were analyzed for the CF, and 1,969 points (GA: 1,000 points, DS: 969 points) were analyzed for the catheter tip movement distance. The GA group demonstrated a significantly higher mean CF (GA: 12.94±5.27 g vs. DS: 11.93±5.11 g; P<0.01), as well as a higher minimum CF (GA: 4.61±3.85 g vs. DS: 3.79±3.98 g, P<0.01), compared with the DS group. Additionally, catheter tip movement distance was significantly shorter in the GA group than in the DS group (GA: 1.65±0.76 mm vs. DS: 2.29±1.10 mm, P<0.01).

Catheter ablation under GA ensures better maintenance of adequate CF and catheter stability than DS.