Key result
Dexmedetomidine plus remifentanil maintains ~6 mmHg higher MAP vs propofol during AF ablation.
Why the study?
The effects of dexmedetomidine combined with remifentanil versus remifentanil alone on hemodynamics and inflammatory responses during atrial fibrillation ablation were not well established.
Does dexmedetomidine combined with remifentanil improve hemodynamic stability and attenuate inflammatory responses in patients undergoing atrial fibrillation ablation compared to propofol with remifentanil?
RCT (n=100)
Outcome assessors blinded
1:1, block size 4, sealed envelopes
No
Does dexmedetomidine combined with remifentanil improve hemodynamic stability and attenuate inflammatory responses in patients undergoing atrial fibrillation ablation compared to propofol with remifentanil?
Mean Difference: 6.2
Absolute Event Rate: 56.45% vs 50.25%
p-value: p=<0.001
Dexmedetomidine combined with remifentanil during atrial fibrillation ablation provides better perioperative hemodynamic stability, improved sedation, and lower inflammatory biomarker levels compared to a propofol-remifentanil regimen.
Favors dexmedetomidine-remifentanil over propofol-remifentanil for hemodynamic stability in AF ablation; extends RCT evidence on procedural sedation regimens.
This randomized controlled trial evaluated dexmedetomidine combined with remifentanil versus remifentanil alone for monitored anesthesia care during radiofrequency catheter ablation for atrial fibrillation. Between January and December 2023, 100 patients were stratified by age, sex, BMI, and atrial fibrillation type, then randomly assigned (1:1, block size 4, sealed envelopes) to Group A (dexmedetomidine 1 μg/kg loading then 0.2–0.4 μg/kg/h plus remifentanil, n = 50) or Group B (saline control plus remifentanil, n = 50). Baseline characteristics were comparable (all P > 0.05). Hemodynamic parameters were recorded at baseline ( T 0 ), 10 min after induction ( T 1 ), maintenance ( T 2 ), 10 min before surgery end ( T 3 ), and at surgery end ( T 4 ). Group A showed higher mean arterial pressure, cardiac index, and cardiac output at T 1 – T 4 ( P < 0.05), with lower heart rate and blood pressure ( P < 0.05). Ramsay Sedation Score was higher at T 3 – T 4 ( P < 0.05). Adverse reactions and inflammatory markers (IL-6, TNF-α, CRP) were attenuated postoperatively ( P < 0.05). Dexmedetomidine combined with remifentanil provides superior hemodynamic stability, enhanced sedation, reduced inflammation, and fewer adverse events during atrial fibrillation ablation.
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Huang et al. (2026) conducted an RCT in Atrial fibrillation undergoing radiofrequency catheter ablation (n=100). Dexmedetomidine combined with remifentanil vs. Propofol combined with remifentanil was evaluated on Mean arterial pressure (MAP) at 10 minutes after maintenance commencement (T2) (p=<0.001). Dexmedetomidine combined with remifentanil significantly improved hemodynamic stability, maintaining a higher mean arterial pressure at 10 minutes of maintenance (56.45 vs 50.25 mmHg) compared to propofol with remifentanil during atrial fibrillation ablation.
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