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Blood pressure and autonomic responses to electrical stimulation of the renal arterial nerves before and after ablation of the renal artery. Int J Cardiol 2014; 177:669-71. [DOI: 10.1016/j.ijcard.2014.09.168] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 09/27/2014] [Indexed: 11/24/2022]
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Nicoara A, Holmquist F, Raggains C, Mathew JP. Anesthesia for Catheter Ablation Procedures. J Cardiothorac Vasc Anesth 2014; 28:1589-603. [DOI: 10.1053/j.jvca.2014.05.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Indexed: 11/11/2022]
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Hilbert S, Rogge C, Papageorgiou P, Hindricks G, Bollmann A. Successful single-sided renal denervation in drug-resistant hypertension and ventricular tachycardia. Clin Res Cardiol 2014; 104:279-81. [PMID: 25384356 DOI: 10.1007/s00392-014-0790-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 11/04/2014] [Indexed: 01/19/2023]
Affiliation(s)
- Sebastian Hilbert
- Department of Electrophysiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
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Sommer P, Rolf S, Piorkowski C, Gaspar T, Huo Y, Piedra C, Richter S, Bollmann A, Arya A, Hindricks G. Nonfluoroscopic Catheter Visualization in Atrial Fibrillation Ablation. Circ Arrhythm Electrophysiol 2014; 7:869-74. [DOI: 10.1161/circep.114.001542] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Philipp Sommer
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Sascha Rolf
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Christopher Piorkowski
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Thomas Gaspar
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Yan Huo
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Carlos Piedra
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Sergio Richter
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Andreas Bollmann
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Arash Arya
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Gerhard Hindricks
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
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Abstract
Abstract
Atrial fibrillation is the most common arrhythmia. The anesthetic considerations of endovascular ablation for the treatment of atrial fibrillation are reviewed.
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HUO YAN, SCHOENBAUER ROBERT, RICHTER SERGIO, ROLF SASCHA, SOMMER PHILIPP, ARYA ARASH, RASTAN ARDAWAN, DOLL NICOLAS, MOHR FRIEDRICHWILHELM, HINDRICKS GERHARD, PIORKOWSKI CHRISTOPHER, GASPAR THOMAS. Atrial Arrhythmias Following Surgical AF Ablation: Electrophysiological Findings, Ablation Strategies, and Clinical Outcome. J Cardiovasc Electrophysiol 2014; 25:725-38. [DOI: 10.1111/jce.12406] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 02/13/2014] [Accepted: 02/17/2014] [Indexed: 11/30/2022]
Affiliation(s)
- YAN HUO
- Department of Electrophysiology; Dresden University-Heart Center; Dresden Germany
| | - ROBERT SCHOENBAUER
- Department of Electrophysiology; Leipzig University-Heart Center; Leipzig Germany
| | - SERGIO RICHTER
- Department of Electrophysiology; Leipzig University-Heart Center; Leipzig Germany
| | - SASCHA ROLF
- Department of Electrophysiology; Leipzig University-Heart Center; Leipzig Germany
| | - PHILIPP SOMMER
- Department of Electrophysiology; Leipzig University-Heart Center; Leipzig Germany
| | - ARASH ARYA
- Department of Electrophysiology; Leipzig University-Heart Center; Leipzig Germany
| | - ARDAWAN RASTAN
- Department of Cardiac Surgery; Rotenburg a. d. Fulda; Germany
| | - NICOLAS DOLL
- Department of Cardiac Surgery; Sana Hospital; Stuttgart Germany
| | | | - GERHARD HINDRICKS
- Department of Electrophysiology; Leipzig University-Heart Center; Leipzig Germany
| | | | - THOMAS GASPAR
- Department of Electrophysiology; Dresden University-Heart Center; Dresden Germany
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Wutzler A, Mueller A, Loehr L, Huemer M, Parwani AS, Attanasio P, Blaschke F, Storm C, Boldt LH, Haverkamp W. Minimal and deep sedation during ablation of ventricular tachycardia. Int J Cardiol 2014; 172:161-4. [DOI: 10.1016/j.ijcard.2013.12.175] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/17/2013] [Accepted: 12/31/2013] [Indexed: 01/17/2023]
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Thomas SP, Thakkar J, Kovoor P, Thiagalingam A, Ross DL. Sedation for electrophysiological procedures. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2014; 37:781-90. [PMID: 24697803 DOI: 10.1111/pace.12370] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Revised: 01/05/2014] [Accepted: 01/07/2014] [Indexed: 12/19/2022]
Abstract
Administration of intravenous sedation (IVS) has become an integral component of procedural cardiac electrophysiology. IVS is employed in diagnostic and ablation procedures for transcutaneous treatment of cardiac arrhythmias, electrical cardioversion of arrhythmias, and the insertion of implantable electronic devices including pacemakers, defibrillators, and loop recorders. Sedation is frequently performed by nursing staff under the supervision of the proceduralist and in the absence of specialist anesthesiologists. The sedation requirements vary depending on the nature of the procedure. A wide range of sedation techniques have been reported with sedation from the near fully conscious to levels approaching that of general anesthesia. This review examines the methods employed and outcomes associated with reported sedation techniques. There is a large experience with the combination of benzodiazepines and narcotics. These drugs have a broad therapeutic range and the advantage of readily available reversal agents. More recently, the use of propofol without serious adverse events has been reported. The results provide a guide regarding the expected outcomes of these approaches. The complication rate and need for emergency assistance is low in reported series where sedation is administered by nonspecialist anesthesiology staff.
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Affiliation(s)
- Stuart P Thomas
- Department of Cardiology, Westmead Hospital and University of Sydney, Sydney, NSW, Australia
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Yamaji H, Murakami T, Hina K, Higashiya S, Kawamura H, Murakami M, Kamikawa S, Hirohata S, Kusachi S. Usefulness of dabigatran etexilate as periprocedural anticoagulation therapy for atrial fibrillation ablation. Clin Drug Investig 2013; 33:409-18. [PMID: 23572324 DOI: 10.1007/s40261-013-0081-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The usefulness of dabigatran etexilate for the prevention of stroke in patients with atrial fibrillation (AF) has been reported. OBJECTIVES In this study the efficacy and safety of dabigatran etexilate for anticoagulation for AF ablation were examined. METHOD Patients were divided into three groups: Group 1, interrupted warfarin bridged by heparin between pre- and post-ablation; Group 2, continuous warfarin therapy; and Group 3, dabigatran etexilate therapy. Anticoagulation therapy with warfarin or dabigatran etexilate was performed from 30 days before to at least 90 days after AF ablation. Dabigatran etexilate was administered at 110 or 150 mg twice daily, depending on renal function and age. RESULTS Patients' clinical characteristics, associated disorders, echocardiographic parameters and arrhythmia status were not different among the three groups. Procedural parameters such as procedural time and radiofrequency energy supply were also not different among the three groups. The dabigatran etexilate group and the warfarin groups had no embolic complications (stroke, cerebral transient ischaemic attack, deep venous thrombosis or pulmonary embolism). No pericardial tamponade was observed in the dabigatran etexilate group, while two patients in each of Group 1 (2/194, 1.0 %) and Group 2 (2/203, 0.98 %) developed cardiac tamponade, though the differences were not significant. Pericardial effusion and groin haematoma were observed in one patient each (1/105, 0.9 %) in the dabigatran etexilate group, and the incidences were not different from the warfarin group (Group 1: 4/194, 2.1 % and 2/194, 1.0 %; Group 2: 3/203, 1.5 % and 2/203, 1.0 %, respectively). As a whole, the safety outcomes did not differ among the three groups. CONCLUSION Dabigatran etexilate is an effective and safe anticoagulation therapy for AF ablation. Thus, dabigatran etexilate appears to be useful as an alternative anticoagulant therapy to warfarin for AF ablation.
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Conway A, Rolley J, Page K, Fulbrook P. Clinical practice guidelines for nurse-administered procedural sedation and analgesia in the cardiac catheterization laboratory: a modified Delphi study. J Adv Nurs 2013; 70:1040-53. [DOI: 10.1111/jan.12337] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2013] [Indexed: 12/11/2022]
Affiliation(s)
- Aaron Conway
- School of Nursing; Institute of Health and Biomedical Innovation; Queensland University of Technology; Kelvin Grove Queensland Australia
- Cardiac Catheter Theatres; The Wesley Hospital; Auchenflower Queensland Australia
- School of Nursing, Midwifery & Paramedicine (QLD); Australian Catholic University; Banyo Queensland Australia
| | - John Rolley
- School of Nursing and Midwifery; Deakin University; Geelong Victoria Australia
| | - Karen Page
- Heart Foundation; Melbourne Victoria Australia
| | - Paul Fulbrook
- School of Nursing, Midwifery & Paramedicine (QLD); Australian Catholic University; Banyo Queensland Australia
- Nursing Research and Practice Development Unit; The Prince Charles Hospital; Chermiside Queensland Australia
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Sbrana F, Ripoli A, Formichi B. Safety and utility of noninvasive ventilation during deep sedation for catheter ablation of atrial fibrillation. J Cardiothorac Vasc Anesth 2013; 28:e6-e8. [PMID: 24295722 DOI: 10.1053/j.jvca.2013.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Bruno Formichi
- Fondazione Toscana Gabriele Monasterio and National Research Council, Institute of Clinical Physiology, Pisa, Italy
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Carnlöf C, Insulander P, Jensen-Urstad M. An active supply of analgesics during pulmonary vein isolation reduces pain. SCAND CARDIOVASC J 2013; 48:35-40. [DOI: 10.3109/14017431.2013.859296] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Wutzler A, Loehr L, Huemer M, Parwani AS, Steinhagen-Thiessen E, Boldt LH, Haverkamp W. Deep sedation during catheter ablation for atrial fibrillation in elderly patients. J Interv Card Electrophysiol 2013; 38:115-21. [PMID: 24013702 DOI: 10.1007/s10840-013-9817-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 06/17/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common cardiac arrhythmia. AF incidence increases with age. AF ablation procedures are routinely performed under deep sedation with propofol. The purpose of the study was to evaluate if propofol deep sedation during AF ablation is safe in elderly patients. METHODS Four hundred one consecutive patients (mean age, 61.4 ± 11.1 years; range, 20-82; 66.3 % men) who were presented to our institution for ablation of symptomatic AF were enrolled. Patients were divided into three groups: Patients in group A were ≤50 years old; patients in group B were 51-74 years old; and patients in group C were ≥75 years old. Procedures were performed under deep sedation with propofol, midazolam, and piritramide. SaO2, electrocardiogram, arterial blood pressure, and arterial blood gas were monitored throughout the procedure. Sedation-related complications, intraprocedural complications, and other adverse events were evaluated. Fisher exact or χ (2) tests were used for comparison of adverse events and complications among groups. Analysis of variance was used to compare sedation- and procedure-related parameters. RESULTS Fifty-three (13.2 %) elderly patients were in group C and were compared to 73 (18.2 %) patients in group A and 275 (68.8 %) in group B. No significant differences in sedation-related or intraprocedural complications were seen (group A, 1.4 %; group B, 1.1 %; group C, 3.7 %; p = 0.336). Despite a significantly greater drop in systolic blood pressure in under sedation in group C (group A, 15.5 ± 9.5 mmHg; group B, 18.9 ± 16.3 mmHg; group C, 32.3 ± 15.5 mmHg; p < 0.001), no prolonged hypotension was observed. The rate of other adverse events (delirium, respiratory infection, renal failure) was significantly higher in group C (9.4 %), compared to group A (0 %) and group B (2.2 %; p = 0.004). CONCLUSION Deep sedation with propofol and midazolam during AF ablation did not result in an increased rate in sedation-related complications in elderly patients. Similarly, the rate of procedural complications was not significantly different among the study groups. The rate of respiratory infections and renal failure was significantly higher in the elderly. All adverse events were treated successfully without any remaining sequelae.
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Affiliation(s)
- Alexander Wutzler
- Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany,
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Rolf S, John S, Gaspar T, Dinov B, Kircher S, Huo Y, Bollmann A, Richter S, Arya A, Hindricks G, Piorkowski C, Sommer P. Catheter ablation of atrial fibrillation supported by novel nonfluoroscopic 4D navigation technology. Heart Rhythm 2013; 10:1293-300. [DOI: 10.1016/j.hrthm.2013.05.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Indexed: 10/26/2022]
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Eitel C, Rolf S, Zachäus M, John S, Sommer P, Bollmann A, Arya A, Piorkowski C, Hindricks G, Halm U. Successful Nonsurgical Treatment of Esophagopericardial Fistulas After Atrial Fibrillation Catheter Ablation. Circ Arrhythm Electrophysiol 2013; 6:675-81. [DOI: 10.1161/circep.113.000384] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Charlotte Eitel
- From the Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany (C.E., S.R., S.J., P.S., A.B., A.A., C.P., G.H.); and Department of Internal Medicine II, Park-Hospital Leipzig, Leipzig, Germany (M.Z., U.H.)
| | - Sascha Rolf
- From the Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany (C.E., S.R., S.J., P.S., A.B., A.A., C.P., G.H.); and Department of Internal Medicine II, Park-Hospital Leipzig, Leipzig, Germany (M.Z., U.H.)
| | - Markus Zachäus
- From the Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany (C.E., S.R., S.J., P.S., A.B., A.A., C.P., G.H.); and Department of Internal Medicine II, Park-Hospital Leipzig, Leipzig, Germany (M.Z., U.H.)
| | - Silke John
- From the Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany (C.E., S.R., S.J., P.S., A.B., A.A., C.P., G.H.); and Department of Internal Medicine II, Park-Hospital Leipzig, Leipzig, Germany (M.Z., U.H.)
| | - Philipp Sommer
- From the Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany (C.E., S.R., S.J., P.S., A.B., A.A., C.P., G.H.); and Department of Internal Medicine II, Park-Hospital Leipzig, Leipzig, Germany (M.Z., U.H.)
| | - Andreas Bollmann
- From the Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany (C.E., S.R., S.J., P.S., A.B., A.A., C.P., G.H.); and Department of Internal Medicine II, Park-Hospital Leipzig, Leipzig, Germany (M.Z., U.H.)
| | - Arash Arya
- From the Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany (C.E., S.R., S.J., P.S., A.B., A.A., C.P., G.H.); and Department of Internal Medicine II, Park-Hospital Leipzig, Leipzig, Germany (M.Z., U.H.)
| | - Christopher Piorkowski
- From the Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany (C.E., S.R., S.J., P.S., A.B., A.A., C.P., G.H.); and Department of Internal Medicine II, Park-Hospital Leipzig, Leipzig, Germany (M.Z., U.H.)
| | - Gerhard Hindricks
- From the Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany (C.E., S.R., S.J., P.S., A.B., A.A., C.P., G.H.); and Department of Internal Medicine II, Park-Hospital Leipzig, Leipzig, Germany (M.Z., U.H.)
| | - Ulrich Halm
- From the Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany (C.E., S.R., S.J., P.S., A.B., A.A., C.P., G.H.); and Department of Internal Medicine II, Park-Hospital Leipzig, Leipzig, Germany (M.Z., U.H.)
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Abstract
Invasive electrophysiologic procedures have evolved and increased in frequency significantly over the past 2 decades. The complexity and nature of the various procedures offered have also changed, and complex ablations for atrial fibrillation and ventricular tachycardia have become commonplace. These procedures often require the services of an anesthesiologist. An understanding of the specific nature and challenges of these procedures may be helpful in planning the optimal anesthetic and patient management. A paired review of these issues has been written from the standpoint of a practicing anesthesiologist. This review is written from the viewpoint of a cardiac electrophysiologist and will focus on the intra-procedural management of patients undergoing both cardiac implantable device implantation as well as catheter-based ablations, with a specific focus on the catheter ablation of atrial fibrillation. Ultimately, the proper management of these patients will facilitate successful procedural outcomes while maintaining a high degree of patient safety.
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Affiliation(s)
- Adam Price
- Loyola University Medical Center, Maywood, IL, USA
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Eitel C, Koch J, Sommer P, John S, Kircher S, Bollmann A, Arya A, Piorkowski C, Hindricks G. Novel oral anticoagulants in a real-world cohort of patients undergoing catheter ablation of atrial fibrillation. Europace 2013; 15:1587-93. [DOI: 10.1093/europace/eut128] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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CERVIGÓN RAQUEL, MORENO JAVIER, PÉREZ-VILLACASTÍN JULIÁN, CASTELLS FRANCISCO. Profound Sedation with Propofol Modifies Atrial Fibrillation Dynamics. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2013; 36:1176-88. [DOI: 10.1111/pace.12137] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 01/17/2013] [Accepted: 02/14/2013] [Indexed: 11/27/2022]
Affiliation(s)
- RAQUEL CERVIGÓN
- Universidad de Castilla7#x02010;La Mancha, DIEEAC, UCLM; Bioengineering Innovation Research Group (GIBI); Cuenca Spain
| | - JAVIER MORENO
- Unidad de Arritmias; Hospital Clínico San Carlos; Madrid Spain
| | | | - FRANCISCO CASTELLS
- Universidad Politécnica de Valencia; Bioengineering Electronic Telemedicine (BET); DIE; Valencia Spain
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Murakami T, Yamaji H, Numa K, Kawamura H, Murakami M, Higashiya S, Kamikawa S, Hina K, Hirohata S, Kusachi S. Adaptive-servo ventilation combined with deep sedation is an effective strategy during pulmonary vein isolation. Europace 2013; 15:951-6. [PMID: 23419657 DOI: 10.1093/europace/eut007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
AIMS Pulmonary vein isolation (PVI) by catheter ablation for atrial fibrillation (AF) requires suppression of patient restlessness by sufficient sedation in addition to maintaining stable respiration. We applied adaptive-servo ventilation (ASV) and examined the effects of ASV combined with deep propofol sedation on PVI using a NavX. METHODS AND RESULTS We analysed 75 paroxysmal AF (PAF) patients (62 ± 11 years; 53 men and 22 women) who underwent PVI for treatment of PAF using an ASV system combined with deep sedation (ASV group). Control patients included 75 consecutive PAF patients (62 ± 11 years; 51 men and 24 women) who underwent PVI just before introduction of the ASV system. Deep sedation was defined as a Ramsay sedation score of 6. The ASV group had a lower frequency of restless body movements compared with the control group during PVI (1.5 ± 0.7 vs. 7.8 ± 1.4 times, P < 0.01). The frequency of respiratory compensation and EnGuide alignment of catheter position by the NavX was lower in the ASV (4.2 ± 3.3 and 8.8 ± 7.1 times) than control group (7.1 ± 5.1 and 15.2 ± 10.0 times, P < 0.05 and <0.01, respectively). Consequently, significantly lower total electrical energy supply (48.7 ± 6.0 KJ) was required in the ASV than control group (64.5 ± 24.9 KJ, P < 0.01). Further, significantly shorter fluoroscopy and procedural times were observed in the ASV (28 ± 5 and 109 ± 25 min) than the control group (33 ± 6 and 141 ± 38 min, respectively, P < 0.01) and the AF recurrence rate was significantly lower in the ASV than the control group (12 vs. 25%, P < 0.01). CONCLUSION ASV combined with deep sedation is an effective strategy during PVI using the NavX in patients with PAF.
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Wutzler A, Huemer M, Boldt LH, Parwani AS, Attanasio P, Tscholl V, Haverkamp W. Effects of deep sedation on cardiac electrophysiology in patients undergoing radiofrequency ablation of supraventricular tachycardia: impact of propofol and ketamine. ACTA ACUST UNITED AC 2013; 15:1019-24. [DOI: 10.1093/europace/eut025] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Raviele A, Natale A, Calkins H, Camm JA, Cappato R, Ann Chen S, Connolly SJ, Damiano R, DE Ponti R, Edgerton JR, Haïssaguerre M, Hindricks G, Ho SY, Jalife J, Kirchhof P, Kottkamp H, Kuck KH, Marchlinski FE, Packer DL, Pappone C, Prystowsky E, Reddy VK, Themistoclakis S, Verma A, Wilber DJ, Willems S. Venice Chart international consensus document on atrial fibrillation ablation: 2011 update. J Cardiovasc Electrophysiol 2013; 23:890-923. [PMID: 22953789 DOI: 10.1111/j.1540-8167.2012.02381.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Antonio Raviele
- Cardiovascular Department, Arrhythmia Center and Center for Atrial Fibrillation, Dell'Angelo Hospital, Venice-Mestre, Italy.
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Ezzat VA, Chew A, McCready JW, Lambiase PD, Chow AW, Lowe MD, Rowland E, Segal OR. Catheter ablation of atrial fibrillation—patient satisfaction from a single-center UK experience. J Interv Card Electrophysiol 2012; 37:291-303. [DOI: 10.1007/s10840-012-9763-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Accepted: 11/13/2012] [Indexed: 10/27/2022]
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Rolf S, Sommer P, Gaspar T, John S, Arya A, Hindricks G, Piorkowski C. Ablation of Atrial Fibrillation Using Novel 4-Dimensional Catheter Tracking Within Autoregistered Left Atrial Angiograms. Circ Arrhythm Electrophysiol 2012; 5:684-90. [DOI: 10.1161/circep.112.971705] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sascha Rolf
- From the Department of Electrophysiology, University of Leipzig—Heart Center, Leipzig, Germany
| | - Philipp Sommer
- From the Department of Electrophysiology, University of Leipzig—Heart Center, Leipzig, Germany
| | - Thomas Gaspar
- From the Department of Electrophysiology, University of Leipzig—Heart Center, Leipzig, Germany
| | - Silke John
- From the Department of Electrophysiology, University of Leipzig—Heart Center, Leipzig, Germany
| | - Arash Arya
- From the Department of Electrophysiology, University of Leipzig—Heart Center, Leipzig, Germany
| | - Gerhard Hindricks
- From the Department of Electrophysiology, University of Leipzig—Heart Center, Leipzig, Germany
| | - Christopher Piorkowski
- From the Department of Electrophysiology, University of Leipzig—Heart Center, Leipzig, Germany
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2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. J Interv Card Electrophysiol 2012; 33:171-257. [PMID: 22382715 DOI: 10.1007/s10840-012-9672-7] [Citation(s) in RCA: 256] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This is a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation, developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology and the European Cardiac Arrhythmia Society (ECAS), and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). This is endorsed by the governing bodies of the ACC Foundation, the AHA, the ECAS, the EHRA, the STS, the APHRS, and the HRS.
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Calkins H, Kuck KH, Cappato R, Brugada J, Camm AJ, Chen SA, Crijns HJG, Damiano RJ, Davies DW, DiMarco J, Edgerton J, Ellenbogen K, Ezekowitz MD, Haines DE, Haissaguerre M, Hindricks G, Iesaka Y, Jackman W, Jalife J, Jais P, Kalman J, Keane D, Kim YH, Kirchhof P, Klein G, Kottkamp H, Kumagai K, Lindsay BD, Mansour M, Marchlinski FE, McCarthy PM, Mont JL, Morady F, Nademanee K, Nakagawa H, Natale A, Nattel S, Packer DL, Pappone C, Prystowsky E, Raviele A, Reddy V, Ruskin JN, Shemin RJ, Tsao HM, Wilber D. 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace 2012; 14:528-606. [PMID: 22389422 DOI: 10.1093/europace/eus027] [Citation(s) in RCA: 1144] [Impact Index Per Article: 95.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Calkins H, Kuck KH, Cappato R, Brugada J, Camm AJ, Chen SA, Crijns HJG, Damiano RJ, Davies DW, DiMarco J, Edgerton J, Ellenbogen K, Ezekowitz MD, Haines DE, Haissaguerre M, Hindricks G, Iesaka Y, Jackman W, Jalife J, Jais P, Kalman J, Keane D, Kim YH, Kirchhof P, Klein G, Kottkamp H, Kumagai K, Lindsay BD, Mansour M, Marchlinski FE, McCarthy PM, Mont JL, Morady F, Nademanee K, Nakagawa H, Natale A, Nattel S, Packer DL, Pappone C, Prystowsky E, Raviele A, Reddy V, Ruskin JN, Shemin RJ, Tsao HM, Wilber D. 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC) and the European Cardiac Arrhythmia Society (ECAS); and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). Endorsed by the governing bodies of the American College of Cardiology Foundation, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm Society. Heart Rhythm 2012; 9:632-696.e21. [PMID: 22386883 DOI: 10.1016/j.hrthm.2011.12.016] [Citation(s) in RCA: 1299] [Impact Index Per Article: 108.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Indexed: 12/20/2022]
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HUMMEL JOHND, ELSAYED-AWAD HAMDY. Walking the Tightrope Between Deep Sedation and General Anesthesia: By Whom Can This Safely Be Done? J Cardiovasc Electrophysiol 2011; 22:1344-5. [DOI: 10.1111/j.1540-8167.2011.02151.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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