Servatius, Helge Simon; Höfeler, Thormen; Hoffmann, Boris A; Sultan, Arian; Lüker, Jakob; Schäffer, Benjamin; Willems, Stephan; Steven, Daniel (2016). Propofol sedation administered by cardiologists for patients undergoing catheter ablation for ventricular tachycardia. Europace, 18(8), euv303. Oxford University Press 10.1093/europace/euv303
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AIMS
Propofol sedation has been shown to be safe for atrial fibrillation ablation and internal cardioverter-defibrillator implantation but its use for catheter ablation (CA) of ventricular tachycardia (VT) has yet to be evaluated. Here, we tested the hypothesis that VT ablation can be performed using propofol sedation administered by trained nurses under a cardiologist's supervision.
METHODS AND RESULTS
Data of 205 procedures (157 patients, 1.3 procedures/patient) undergoing CA for sustained VT under propofol sedation were analysed. The primary endpoint was change of sedation and/or discontinuation of propofol sedation due to side effects and/or haemodynamic instability. Propofol cessation was necessary in 24 of 205 procedures. These procedures (Group A; n = 24, 11.7%) were compared with those with continued propofol sedation (Group B; n = 181, 88.3%). Propofol sedation was discontinued due to hypotension (n = 22; 10.7%), insufficient oxygenation (n = 1, 0.5%), or hypersalivation (n = 1, 0.5%). Procedures in Group A were significantly longer (210 [180-260] vs. 180 [125-220] min, P = 0.005), had a lower per hour propofol rate (3.0 ± 1.2 vs. 3.8 ± 1.2 mg/kg of body weight/h, P = 0.004), and higher cumulative dose of fentanyl administered (0.15 [0.13-0.25] vs. 0.1 [0.05-0.13] mg, P < 0.001), compared with patients in Group B. Five (2.4%) adverse events occurred.
CONCLUSION
Sedation using propofol can be safely performed for VT ablation under the supervision of cardiologists. Close haemodynamic monitoring is required, especially in elderly patients and during lengthy procedures, which carrying a higher risk for systolic blood pressure decline.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Kardiologie 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Kardiologie |
UniBE Contributor: |
Servatius, Helge Simon (A) |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1099-5129 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Helge Simon Servatius |
Date Deposited: |
19 Jul 2016 11:32 |
Last Modified: |
29 Mar 2023 23:34 |
Publisher DOI: |
10.1093/europace/euv303 |
PubMed ID: |
27247017 |
Uncontrolled Keywords: |
Adverse events; Catheter ablation; Propofol; Sedation; Ventricular tachycardia |
BORIS DOI: |
10.7892/boris.83857 |
URI: |
https://boris.unibe.ch/id/eprint/83857 |
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