Journal article
General anesthesia reduces the prevalence of pulmonary vein reconnection during repeat ablation when compared with conscious sedation: Results from a randomized study
Heart rhythm, Vol.8(3), pp.368-372
03/01/2011
DOI: 10.1016/j.hrthm.2010.10.043
PMID: 21055479
Abstract
Radiofrequency catheter ablation of atrial fibrillation can be performed under general anesthesia or conscious sedation at the physician's preference.
We randomized a series of consecutive patients with paroxysmal atrial fibrillation (AF) undergoing radiofrequency catheter ablation to either general anesthesia or conscious sedation to assess differences in pulmonary vein (PV) reconnection during redo procedures and impact on success rate.
A total of 257 consecutive patients with paroxysmal AF undergoing AF ablation were enrolled and randomized to either conscious sedation with fentanyl or midazolam (128 patients, group 1) and general anesthesia (129 patients, group 2). In all patients, a high dosage of isoproterenol up to 30 μg/min was used to disclose PV reconnection or extra PV firings.
Baseline clinical characteristics were not significantly different between the 2 groups. At 17 ± 8 month follow-up after the first ablation, 88 (69%) patients in group 1 were free of atrial arrhythmias off all antiarrhythmic drugs (AAD), as compared with 114 (88%) in group 2 (log-rank
P <.001). All patients with recurrence had a second procedure. At the repeat procedure, 42% (66 of 158) of PVs in group 1 had recovered PV conduction, compared with 19% (11 of 57) in group 2 (
P = .003). Compared with group 1, group 2 had a significantly shorter fluoroscopy time (53 ± 9 min vs. 84 ± 21 min,
P <.001) and procedure time (2.4 ± 1.4 h vs. 3.6 ± 1.1 h,
P <.001).
The use of general anesthesia is associated with higher cure rate with a single procedure, and it seems to reduce the prevalence of PV reconnection observed at the time of repeat ablation.
Details
- Title: Subtitle
- General anesthesia reduces the prevalence of pulmonary vein reconnection during repeat ablation when compared with conscious sedation: Results from a randomized study
- Creators
- Luigi Di Biase - Texas Cardiac ArrhythmiaSergio Conti - Texas Cardiac ArrhythmiaPrasant Mohanty - Texas Cardiac ArrhythmiaRong Bai - Texas Cardiac ArrhythmiaJavier Sanchez - Texas Cardiac ArrhythmiaDavid Walton - Austin Anesthesiology Group, LLP, Austin, TexasAnnie John - Austin Anesthesiology Group, LLP, Austin, TexasPasquale Santangeli - Università Cattolica del Sacro CuoreClaude S. Elayi - University of KentuckySalwa Beheiry - California Pacific Medical Center, San Francisco, CaliforniaG. Joseph Gallinghouse - Texas Cardiac ArrhythmiaSanghamitra Mohanty - Texas Cardiac ArrhythmiaRodney Horton - Texas Cardiac ArrhythmiaShane Bailey - Texas Cardiac ArrhythmiaJ. David Burkhardt - Texas Cardiac ArrhythmiaAndrea Natale - Texas Cardiac Arrhythmia
- Resource Type
- Journal article
- Publication Details
- Heart rhythm, Vol.8(3), pp.368-372
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.hrthm.2010.10.043
- PMID
- 21055479
- ISSN
- 1547-5271
- eISSN
- 1556-3871
- Number of pages
- 5
- Language
- English
- Date published
- 03/01/2011
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984822987502771
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