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KMID : 1011920190200010001
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International Journal of Arrhythmia
2019 Volume.20 No. 1 p.1 ~ p.1
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Randomized comparison between dexmedetomidine?remifentanil and midazolam?fentanyl for deep sedation during catheter ablation of atrial fibrillation
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Choi Young
Kim Sung-Hwan
Kim Ju-Youn
Hwang You-Mi
Kim Tae-Seok
Kim Ji-Hoon
Jang Sung-Won
Lee Man-Young
Oh Yong-Seog
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Abstract
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Background and objectives: The efficacy of dexmedetomidine for radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) has not been well established. We evaluated the efficacy and safety of sedation using dexmedetomidine with remifentanil compared to conventional sedative agents during RFCA for AF.
Subjects and methods: A total of 240 patients undergoing RFCA for AF were randomized to either the dexmedetomidine (DEX) group (continuous infusion of dexmedetomidine and remifentanil) or the midazolam (MID) group (intermittent injections of midazolam and fentanyl) according to sedative agents. Non-invasive positive pressure ventilation was applied to all patients during the procedure. The primary outcome was patient movement during the procedure resulting in a 3D mapping system discordance, and the secondary outcome was adverse events including respiratory or hemodynamic compromise.
Results: During AF ablation, the incidence of the primary outcome was significantly reduced for the DEX group (18.2% vs. 39.5% in the DEX and the MID groups, respectively, p?
Conclusion: The combined use of dexmedetomidine and remifentanil provides higher stability sedation during AF ablation, but can lead to more frequent hemodynamic compromise compared to midazolam and fentanyl.
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KEYWORD
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Atrial fibrillation, Radiofrequency catheter ablation, Dexmedetomidine, Midazolam, Sedation
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