ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2025
Feasibility of pulsed field ablation for atrial fibrillation under mild conscious sedation.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sedation vs. general anaesthesia in patients with atrial fibrillation undergoing catheter ablation: a systematic review and meta-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Pooled it
- Anaesthetic Techniques for Cardiac Ablation-A Scoping Review.Acta anaesthesiologica Scandinavica · 2026Article
- Monitored anesthesia care versus general anesthesia for balloon-in-basket pulsed-field ablation of atrial fibrillation: an age-matched analysis of procedural timing and acute procedural outcomes.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Patient-Reported Outcome Measures Following Pulsed-Field Ablation Versus Thermal Ablation of Atrial Fibrillation: The PROMs-PFA Study.Journal of cardiovascular electrophysiology · 2026Article
- Sedation Strategies, Drugs, and Protocols Used in Catheter Ablation of Atrial Fibrillation: A Focused Review.Reviews in cardiovascular medicine · 2026Review
- Circular over-the-wire pulsed field ablation for atrial fibrillation: differences in outcomes between conscious sedation or general anesthesia.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- "Awake and Ablated": First experience with a balloon-in-basket PFA system without propofol.Heart rhythm O2 · 2026Article
- Environmental Impact of Pentaspline Pulsed Field Ablation-Global Warming or Arctic Front?Journal of health economics and outcomes research · 2026Article
- Impact of Pulsed-Field Ablation on the Left Atrial Appendage Diameter-Insights From Intra-Procedural Echocardiography.Journal of cardiovascular electrophysiology · 2025Observational
- Minimizing Atrioesophageal Fistula Risk After AF Ablation: Risk Factors, Prevention, and Emerging Mini-Thermal Technology.Pacing and clinical electrophysiology : PACE · 2025Review
- Asmeton minimizes dry cough and diaphragmatic contraction during pulsed-field ablation of atrial fibrillation: a clinical prospective randomized study.Frontiers in physiology · 2025Article
- Anaesthesia for Pulsed Field Ablation Procedures.Arrhythmia & electrophysiology review · 2025Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulsed field ablation (PFA) is a new modality for pulmonary vein isolation (PVI) for atrial fibrillation (AF). PFA is performed under general anaesthetic (GA) or deep sedation with propofol, but this requires anaesthetic support in many countries, restricting use. No study has tested the feasibility of PFA under mild conscious sedation (MCS).
methodsWe prospectively recruited patients undergoing PFA PVI, offered the option of MCS delivered by electrophysiologists, and compared these with patients who opted for GA. MCS comprised intravenous midazolam and fentanyl. All procedures were performed under anaesthetic supervision in case of requirement to convert to GA, which formed the primary outcome.
resultsTwenty-three patients were recruited (8 MCS, 15 GA). One patient (1/8 [12.5%]) required conversion from MCS to GA. Total procedural times were similar between groups (MCS 92 ± 12.4 min vs. GA 101 ± 17.3 min; p = 0.199). High mean sedative doses were required in the MCS group (5.12 ± 0.83 mg midazolam and 209 ± 40 mcg fentanyl). Median intraprocedural pain perception by the patient, rated from 0 to 100 was 45 (IQR 22.5-72.5) in the MCS group. Post-procedural groin pain (0 [0-0] vs. 5 [0-35]; p = 0.027) and throat pain (0 [0-0] vs. 10 [5-40]; p = 0.001) were lower in the MCS group.
conclusionPFA under MCS is feasible in selected patients but pain and tolerance may be suboptimal, and high sedative doses are required.
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