Deep sedation is a safe, efficient, and resource-conscious alternative to general anaesthesia for pulsed field ablation procedures when implemented with standardized protocols and trained personnel.
This review highlights that structured deep sedation protocols can provide a safe and efficient alternative to general anaesthesia for patients undergoing pulsed field ablation, potentially optimizing electrophysiology lab workflows.
Pulsed field ablation (PFA) is a novel, non-thermal technology used in catheter ablation procedures. Despite its growing clinical adoption, a standardised sedation protocol has not yet been established. Well-coordinated anaesthesia management is essential for procedural success, patient safety and comfort. This review examines various sedation strategies, highlighting their respective benefits and risks, and offers practical recommendations to optimise anaesthesia management during PFA procedures. PFA enables selective myocardial ablation while preserving surrounding structures such as the oesophagus and phrenic nerve. However, inadequate sedation may lead to complications such as haemodynamic instability or airway issues. This article provides an overview of sedation protocols, monitoring strategies and anaesthetic challenges to enhance the safety and efficiency of PFA procedures. Proper anaesthesia planning plays a crucial role in ensuring the safe and successful execution of PFA and contributes to the development of standardised protocols in cardiac electrophysiology.
Heeger et al. (Thu,) conducted a review in Cardiac arrhythmias undergoing pulsed field ablation. Anaesthesia strategies (Deep sedation, General anaesthesia) was evaluated. Deep sedation is a safe, efficient, and resource-conscious alternative to general anaesthesia for pulsed field ablation procedures when implemented with standardized protocols and trained personnel.