Dexmedetomidine versus Propofol for Operator-Directed Nurse-Administered Procedural Sedation during Catheter Ablation of Atrial Fibrillation: a Randomized Controlled Study.

Servatius, Helge; Küffer, Thomas; Baldinger, Samuel H.; Asatryan, Babken; Seiler, Jens; Tanner, Hildegard; Novak, Jan; Lam, Anna; Noti, Fabian; Haeberlin, Andreas; Madaffari, Antonio; Sweda, Romy; Mühl, Aline; Branca, Mattia; Dütschler, Sophie; Erdoes, Gabor; Stüber, Frank; Theiler, Lorenz; Reichlin, Tobias and Roten, Laurent (2022). Dexmedetomidine versus Propofol for Operator-Directed Nurse-Administered Procedural Sedation during Catheter Ablation of Atrial Fibrillation: a Randomized Controlled Study. Heart rhythm, 19(5), pp. 691-700. Elsevier 10.1016/j.hrthm.2021.12.028

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Operator-directed nurse-administered (ODNA) sedation with propofol is the preferred sedation technique for catheter ablation of atrial fibrillation (AF) in many centers.


We aimed to investigate whether Dexmedetomidine, an α2-adrenergic receptor agonist, is superior to propofol.


We randomized 160 consecutive patients undergoing first AF ablation to ODNA sedation by dexmedetomidine (DEX group) versus propofol (PRO group), according to a standardized protocol. Patients were unaware of treatment allocation. The primary endpoint was a composite of inefficient sedation, termination/change of sedation protocol or procedure abortion, hypercapnia (transcutaneous CO2 >55 mmHg), hypoxemia (SpO2 <90%) or intubation, prolonged hypotension (systolic blood pressure <80 mmHg), and sustained bradycardia necessitating cardiac pacing. Secondary endpoints were the components of the primary endpoint and patient satisfaction with procedural sedation, as assessed by a standardized questionnaire the day following ablation.


The primary endpoint occurred in 15 DEX group and 25 PRO group patients (19% vs. 31%; p=0.068). Hypercapnia was significantly more frequent in PRO group patients (29% vs. 10%; p=0.003). There was no significant difference among the other components of the primary endpoint, no procedure was aborted. Patient satisfaction was significantly better in PRO group patients (visual analog scale 0-100; median 100 in PRO group vs. median 93 in DEX group; p<0.001).


Efficacy of ODNA sedation with dexmedetomidine was not different to propofol. Hypercapnia occurs less frequent with dexmedetomidine, but patient satisfaction is better with propofol sedation. In selected patients, dexmedetomidine may be used as an alternative to propofol for ODNA sedation during AF ablation. ( number NCT03844841).

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Department of Clinical Research (DCR)

UniBE Contributor:

Servatius, Helge Simon (A), Kueffer, Thomas, Baldinger, Samuel Hannes, Asatryan, Babken, Seiler, Jens, Tanner, Hildegard, Novak, Jan, Lam, Anna, Noti, Fabian, Häberlin, Andreas David Heinrich, Madaffari, Antonio, Sweda, Romy, Mühl, Aline, Branca, Mattia, Erdoes, Gabor (B), Stüber, Frank, Reichlin, Tobias Roman, Roten, Laurent


600 Technology > 610 Medicine & health








Doris Kopp Heim

Date Deposited:

04 Jan 2022 19:35

Last Modified:

20 Feb 2024 14:16

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Sedation atrial fibrillation catheter ablation dexmedetomidine propofol




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