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Impact of deep sedation on the electrophysiological behavior of pulmonary vein and non-PV firing during catheter ablation for atrial fibrillation

  • Ryohsuke Narui
  • Seiichiro MatsuoEmail author
  • Ryota Isogai
  • Kenichi Tokutake
  • Kenichi Yokoyama
  • Mika Kato
  • Keiichi Ito
  • Shin-ichi Tanigawa
  • Seigo Yamashita
  • Michifumi Tokuda
  • Keiichi Inada
  • Kenri Shibayama
  • Satoru Miyanaga
  • Kenichi Sugimoto
  • Michihiro Yoshimura
  • Teiichi Yamane
Article

Abstract

Purpose

Catheter ablation for atrial fibrillation is performed with and without deep sedation, which could affect the arrhythmogenic activity during the procedure. We investigated the impact of sedation on electrophysiological properties in patients with AF who underwent catheter ablation.

Methods

This study consisted of 255 consecutive patients with atrial fibrillation (229 males, persistent: 105 patients) who underwent a single-catheter ablation procedure. The patients were divided into the following two groups according to the depth of sedation during the procedure: group M (mild sedation with flunitrazepam in 138 patients) and group D (deep sedation with propofol in 117 patients). Peripheral oxygen saturation was continuously monitored via pulse oximetry throughout the procedure.

Results

A spontaneous dissociated pulmonary vein activity after pulmonary vein isolation occurred more frequently in group M than in group D (29.1 vs 15.7%, P < 0.01). Adenosine-induced dormant pulmonary vein conduction was more frequently observed in group M than in group D (19.2 vs 13.0% P = 0.01). There were no significant differences in the incidence of non-pulmonary vein triggers between groups M and D (15.2 vs 11.1%, P = 0.53). The atrial fibrillation recurrence rate following the single procedure did not differ between the two groups (29.0 vs 26.5%, in groups M and D, P = 0.85).

Conclusions

Although deep sedation reduced the incidence of a dissociated pulmonary vein activity and dormant pulmonary vein conduction following pulmonary vein isolation, it did not affect the recurrence rate for atrial fibrillation after the procedure.

Keywords

Atrial fibrillation Catheter ablation Deep sedation Electrophysiological property Propofol Pulmonary vein Non-pulmonary vein foci 

Notes

Acknowledgments

We are grateful to Dr. Brian Quinn (Editor-in-Chief, Japan Medical Communication) for providing linguistic comments on the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Ryohsuke Narui
    • 1
  • Seiichiro Matsuo
    • 1
    Email author
  • Ryota Isogai
    • 1
  • Kenichi Tokutake
    • 1
  • Kenichi Yokoyama
    • 1
  • Mika Kato
    • 1
  • Keiichi Ito
    • 1
  • Shin-ichi Tanigawa
    • 1
  • Seigo Yamashita
    • 1
  • Michifumi Tokuda
    • 1
  • Keiichi Inada
    • 1
  • Kenri Shibayama
    • 1
  • Satoru Miyanaga
    • 1
  • Kenichi Sugimoto
    • 1
  • Michihiro Yoshimura
    • 1
  • Teiichi Yamane
    • 1
  1. 1.Department of CardiologyThe Jikei University School of MedicineTokyoJapan

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