Electrophysiology Team-Administered Conscious Sedation for Pulsed-Field Versus Radiofrequency Ablation in Atrial Fibrillation.
- 1Department of Cardiology Beijing Tiantan Hospital Capital Medical University Beijing China ccmu.edu.cn.
- 2Cardiac Arrhythmia Center Fuwai Hospital National Key Laboratory National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China cacms.ac.cn.
Abstract
Background
Pulsed-field ablation (PFA) is emerging as a novel nonthermal alternative. However, PFA is commonly performed under general anesthesia or deep sedation requiring anesthesiologists, which increases resource utilization and limits its widespread application. This study aimed to evaluate the feasibility of conscious sedation for PFA administered by the electrophysiology (EP) team, using radiofrequency ablation (RFA) as a comparator.Methods
A total of 120 patients with symptomatic, drug-refractory atrial fibrillation were randomized in a 1:1 ratio to the PFA group or the RFA group. We evaluated three key outcomes: (1) intraoperative patient tolerance, assessed using validated scales (Faces Pain Scale-Revised [FPS-R], Likert Scale Questionnaire [LSQ]) combined with intraoperative body movement and cough reactions; (2) procedural efficiency; and (3) procedural safety.Results
The incidence of pain during pulmonary vein isolation was comparable between the two groups (all p > 0.05), whereas FPS-R scores were significantly lower in the PFA group (p < 0.05). No significant difference was observed in movement scores between the two groups (p = 0.452). According to the LSQ analysis, only 1 patient (1.7%) in the RFA group reported dissatisfaction with intraoperative pain management. Cough incidence during PVI was higher with PFA (21.7% [13/60] vs 6.7% [4/60]; p = 0.018). Both total procedure time and left atrial dwell time were shorter in the PFA group. Furthermore, no serious complications were directly related to conscious sedation.Conclusion
In selected low-risk patients, EP team-administered conscious sedation is feasible for PFA, with acceptable intraoperative tolerance and safety while preserving procedural efficiency.
Related
- Efficacy and safety of conscious/deep sedation versus general anesthesia in pulsed field ablation for atrial fibrillation: a systematic review and meta-analysis
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- Predictive Value of Left Atrial Strain Combined with Low-Voltage Substrate for Recurrence After Radiofrequency Catheter Ablation in Persistent Atrial Fibrillation
- Radiofrequency ablation with a conventional solid tip catheter in contact with an implantable cardioverter-defibrillator coil causing inadvertent ventricular fibrillation.
BibTeX
@article{cheng2026electrophysiology,
title = {{Electrophysiology Team-Administered Conscious Sedation for Pulsed-Field Versus Radiofrequency Ablation in Atrial Fibrillation.}},
author = {Li Cheng and Yu Xia and Zhicheng Hu and Tao Zhang and Le Li and Xu Meng and Yulong Xiong and Qin Xu and Zhenhao Zhang and Guanzhi Chen and Ligang Ding and Yan Yao},
journal = {Anesthesiology research and practice},
year = {2026},
month = oct,
doi = {10.1155/anrp/4197770},
url = {https://europepmc.org/article/MED/42959876},
note = {CC BY},
}
RIS
TY - JOUR
TI - Electrophysiology Team-Administered Conscious Sedation for Pulsed-Field Versus Radiofrequency Ablation in Atrial Fibrillation.
AU - Li Cheng
AU - Yu Xia
AU - Zhicheng Hu
AU - Tao Zhang
AU - Le Li
AU - Xu Meng
AU - Yulong Xiong
AU - Qin Xu
AU - Zhenhao Zhang
AU - Guanzhi Chen
AU - Ligang Ding
AU - Yan Yao
PY - 2026
DA - 2026/10/29
JO - Anesthesiology research and practice
DO - 10.1155/anrp/4197770
UR - https://europepmc.org/article/MED/42959876
AB - Background Pulsed-field ablation (PFA) is emerging as a novel nonthermal alternative. However, PFA is commonly performed under general anesthesia or deep sedation requiring anesthesiologists, which increases resource utilization and limits its widespread application. This study aimed to evaluate the feasibility of conscious sedation for PFA administered by the electrophysiology (EP) team, using radiofrequency ablation (RFA) as a comparator.Methods A total of 120 patients with symptomatic, drug-refractory atrial fibrillation were randomized in a 1:1 ratio to the PFA group or the RFA group. We evaluated three key outcomes: (1) intraoperative patient tolerance, assessed using validated scales (Faces Pain Scale-Revised [FPS-R], Likert Scale Questionnaire [LSQ]) combined with intraoperative body movement and cough reactions; (2) procedural efficiency; and (3) procedural safety.Results The incidence of pain during pulmonary vein isolation was comparable between the two groups (all p > 0.05), whereas FPS-R scores were significantly lower in the PFA group (p < 0.05). No significant difference was observed in movement scores between the two groups (p = 0.452). According to the LSQ analysis, only 1 patient (1.7%) in the RFA group reported dissatisfaction with intraoperative pain management. Cough incidence during PVI was higher with PFA (21.7% [13/60] vs 6.7% [4/60]; p = 0.018). Both total procedure time and left atrial dwell time were shorter in the PFA group. Furthermore, no serious complications were directly related to conscious sedation.Conclusion In selected low-risk patients, EP team-administered conscious sedation is feasible for PFA, with acceptable intraoperative tolerance and safety while preserving procedural efficiency.
SN - 1687-6962
SN - 1687-6970
ER -