Key result
Deep sedation with intravenous anesthesia during cryoballoon ablation for paroxysmal atrial fibrillation significantly reduced the recurrence of atrial arrhythmia compared to local anesthesia (9.8% vs 25%, p=0.019).
Why the study?
Whether deep sedation with intravenous anesthesia affects recurrence after cryoballoon ablation for paroxysmal AF had not yet been examined.
Does deep sedation with intravenous anesthesia reduce the recurrence of atrial arrhythmia in patients with symptomatic drug-refractory paroxysmal atrial fibrillation undergoing cryoballoon ablation?
Cohort (n=109)
Yes
Does deep sedation with intravenous anesthesia reduce the recurrence of atrial arrhythmia in patients with symptomatic drug-refractory paroxysmal atrial fibrillation undergoing cryoballoon ablation?
Absolute Event Rate: 9.8% vs 25%
p-value: p=0.019
Deep sedation with intravenous anesthesia during cryoballoon ablation for paroxysmal atrial fibrillation is safe and associated with a significantly lower rate of long-term arrhythmia recurrence compared to local anesthesia.
Deep sedation was associated with lower arrhythmia recurrence after cryoballoon ablation; hypothesis-generating cohort data require randomized confirmation before practice change.
Whether deep sedation with intravenous anesthesia will affect the recurrence after cryoballoon ablation (CBA) of paroxysmal atrial fibrillation (AF) is yet to be examined. Thus, in this study, we hypothesize that there is difference in terms of the recurrence between local anesthesia and deep sedation with intravenous anesthesia after an index ablation procedure.In total, 109 patients were enrolled and received CBA, of which 68 (58.2 years) patients underwent pulmonary vein (PV) isolation with a local anesthesia (group 1) and 41 patients (63.2 years) underwent PV isolation with deep sedation using intravenous anesthesia (group 2).During the index procedure, isolation of all major PVs was achieved in 66 patients in group 1 and in 41 patients in group 2. There was no difference in non-PV triggers between the two groups. The periprocedural complication was found to be similar between the two groups (2.9% in group 1 and 4.9% in group 2). Further, 17 patients in group 1 and 4 patients in group 2 experienced recurrences after a follow-up of 19.3 months (P = 0.019). Repeat procedures revealed similar PV reconnection rates between the two groups. It has also been noted that the number of reconnected PV and incidence of atypical flutter seem to increase in group 1.Deep sedation with intravenous anesthesia during CBA for paroxysmal AF is safe and had a better long-term outcome than those with local anesthesia.
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Chang et al. (2021) conducted a cohort in Paroxysmal Atrial Fibrillation (n=109). Deep sedation with intravenous anesthesia vs. Local anesthesia was evaluated on Recurrence of atrial arrhythmia (p=0.019). Deep sedation with intravenous anesthesia during cryoballoon ablation for paroxysmal atrial fibrillation significantly reduced the recurrence of atrial arrhythmia compared to local anesthesia (9.8% vs 25%, p=0.019).
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