Anaesthetic Techniques for Cardiac Ablation-A Scoping Review

Cardiac arrhythmias, particularly atrial fibrillation, have rising prevalence and represent a growing global health burden. Catheter ablation is a commonly used treatment demanding sedation or anaesthesia for comfort, stability and safety. Anaesthetic techniques vary globally, and the optimal strategy has yet to be determined. The objective of this scoping review was to map the current literature on anaesthesia for catheter ablation, identifying how it has been investigated and which evidence gaps exist.

This scoping review followed a pre-published protocol and guidelines. A search was conducted in MEDLINE, EMBASE, Cochrane, Google Scholar, and Scopus, with no restrictions on publication year or language. Eligible studies were primary studies involving adult patients undergoing catheter ablation in hospitals, clinics, or similar healthcare facilities.

We included 110 studies published between 1991 and 2025. The reported anaesthetic techniques included General Anaesthesia (GA), Deep Sedation (DS), Conscious Sedation (CS), Minimal Sedation, and Local Anaesthesia (LA). Complications were infrequently reported, recovery was comparable, and patient and operator satisfaction was high across techniques. Techniques varied across regions, with GA being most frequent in North America, GA and CS in Asia, and DS in Europe. Anaesthesia quality was commonly assessed by intraprocedural respiratory and haemodynamic stability and complication rates, whilst anaesthesia effectiveness was mostly assessed using procedure duration, accumulated medication, sedation depth, and sedation failure/escalation.

This scoping review mapped current anaesthetic practices in catheter ablations. GA, DS, and CS were most frequently reported. Complications were infrequent and satisfaction high. However, evidence gaps and inconsistent definitions and assessment methods highlight the need for future research and standardisation.

Electrophysiological cardiac interventions such as catheter ablations commonly now also involve anaesthesiological management. This scoping review presents an update on knowledge for how this care may facilitate good procedural results.