Key result
General anesthesia during pulmonary vein isolation significantly improved ablation catheter stability compared to conscious sedation, reducing the median distance traveled by the catheter tip per second from 1.25 to 0.92 (p=0.01).
Why the study?
Catheter ablation for AF is performed under GA or CS, but whether GA improves ablation catheter stability compared with CS during PVI remained unclear.
Does general anesthesia improve ablation catheter stability during pulmonary vein isolation in patients with atrial fibrillation compared to conscious sedation?
Observational (n=30)
No
Does general anesthesia improve ablation catheter stability during pulmonary vein isolation in patients with atrial fibrillation compared to conscious sedation?
Absolute Event Rate: 0.92% vs 1.25%
p-value: p=0.01
General anesthesia during pulmonary vein isolation for atrial fibrillation significantly improves ablation catheter stability compared to conscious sedation, potentially contributing to safer and more effective procedures.
General anesthesia was associated with better catheter stability in this cohort; leaves open effects on ablation outcomes pending randomized trials.
Catheter ablation for atrial fibrillation (AF), during pulmonary vein isolation (PVI), is performed under general anesthesia (GA) or conscious sedation (CS). GA during PVI may improve treatment outcomes, via improving catheter stability. However, the improvement in catheter stability with GA compared to that with CS is unclear. Therefore, we aimed to verify the influence of GA on ablation catheter stability during PVI compared with that of CS by directly assessing catheter movement. Patients who underwent initial ablation using the EnSite Precision™ mapping system were recruited. The patients were divided into two groups (GA group or CS group), and the ablation catheter stability during PVI by the distance traveled by the catheter distal tip per second, clinical periprocedural characteristics, and periprocedural complications was compared. Among 69 consecutive patients, data from 30 patients (17 patients in the GA group and 13 patients in the CS group) and the distance traveled per second on 148,976 points/patient were evaluated. The GA group had a significantly smaller catheter tip travel distance than the CS group (0.92 (0.82‒1.16 vs. 1.25 (1.14‒1.38), p = 0.01). Therefore, GA during PVI for AF provides greater catheter stability than CS, which may contribute to more accessible and safer PVI procedures.
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Kuno et al. (2023) conducted an observational in Atrial fibrillation (n=30). General anesthesia vs. Conscious sedation was evaluated on Distance traveled by the catheter distal tip per second (p=0.01). General anesthesia during pulmonary vein isolation significantly improved ablation catheter stability compared to conscious sedation, reducing the median distance traveled by the catheter tip per second from 1.25 to 0.92 (p=0.01).
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