• Curr Opin Anaesthesiol · Jun 2023

    Review

    Optimization of procedural sedation and analgesia during atrial fibrillation ablation.

    • Marloes C Homberg, BoumanEsther A CEAC, and Bert A J Joosten.
    • Marloes Homberg, Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.
    • Curr Opin Anaesthesiol. 2023 Jun 1; 36 (3): 354360354-360.

    Purpose Of ReviewThis mini-review is aimed to provide an overview and discuss procedural sedation and analgesia for atrial fibrillation (AF) ablation with focus at qualification of staff, patient evaluation, monitoring, medication and postprocedural care.Recent FindingsSleep-disordered breathing is highly prevalent in patients with AF. Impact of often used STOP-BANG questionnaire to detect sleep-disordered breathing in AF patients is limited due to its restricted validity. Dexmedetomidine is a commonly used drug in sedation, but is shown not to be superior to propofol in sedation during AF-ablation. Alternatively use of remimazolam has characteristics that makes it a promising drug for minimal to moderate sedation for AF-ablation. High flow nasal oxygen (HFNO) has shown to reduce the risk of desaturation in adults receiving procedural sedation and analgesia.SummaryAn optimal sedation strategy during AF ablation should be based on AF patient characteristics, the level of sedation needed, the procedure (duration and type of ablation) and the education and experience of the sedation provider. Patient evaluation and post procedural care are part of sedation care. More personalized care based on use of various sedation strategies and types of drugs as related to the type of AF-ablation is the way to further optimize care.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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