Minciună Ioan-Alexandru, Tomoaia Raluca, Suceveanu Mihai, Cismaru Gabriel, Puiu Mihai, Roșu Radu, Simu Gelu, Irimie Diana Andrada, Frîngu Florina, Caloian Bogdan, Andronache Marius, Zdrenghea Dumitru, Pop Dana
5th Department of Internal Medicine, Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania.
Cardiology Department, Rehabilitation Hospital, 400066 Cluj-Napoca, Romania.
J Pers Med. 2024 Aug 16;14(8):865. doi: 10.3390/jpm14080865.
Atrial fibrillation (AF) is the most common cardiac arrhythmia globally. High-power, short-duration radiofrequency (RF) catheter ablation (CA) for AF has recently emerged, reducing ablation times and enhancing patient tolerability with comparable efficacy and safety. While the benefits of general anesthesia (GA) for standard-power, standard-duration CA are well-established, data comparing GA to mild conscious sedation (MCS) for high-power, short-duration CA are limited.
We included patients undergoing high-power, short-duration CA for AF under GA (group 1) or MCS (group 2). Procedural characteristics, success rates, and mid-term outcomes were compared.
In total, 131 patients, 47 in the GA group and 84 in the MCS group, were included. CA was performed for paroxysmal AF in 34 patients in group 1 (72.3%) and 68 patients in group 2 (80.9%). We found lower a mean total procedure time (100 [90-120] vs. 160 [130-180] min, < 0.0001), lower radiation exposure (932.5 [625-1716] vs. 2445 [1228-4791] μGy, < 0.0001 and 4.5 [3-7.1] 7.3 [4.2-13.5] min, = 0.0003) and fewer RF applications (71 [54.8-83.8] vs. 103 [88.5-120.5], < 0.0001) in the GA group. No major complications occurred. The 6-month AF recurrence rate was comparable between the groups (21.2% vs. 33.3%, = 0.15).
In patients undergoing high-power, short-duration RFCA for AF, the use of GA is associated with better procedural efficiency while simultaneously associated with an early recurrence rate comparable to MCS.
心房颤动（AF）是全球最常见的心律失常。用于房颤的高功率、短持续时间射频（RF）导管消融（CA）最近出现，减少了消融时间并提高了患者耐受性，且疗效和安全性相当。虽然全身麻醉（GA）用于标准功率、标准持续时间CA的益处已得到充分证实，但比较GA与轻度清醒镇静（MCS）用于高功率、短持续时间CA的数据有限。
我们纳入了在GA（第1组）或MCS（第2组）下接受高功率、短持续时间房颤CA的患者。比较了手术特征、成功率和中期结果。
总共纳入了131例患者，GA组47例，MCS组84例。第1组34例患者（72.3%）和第2组68例患者（80.9%）进行了阵发性房颤的CA。我们发现GA组的平均总手术时间更低（100 [90 - 120] 分钟 vs. 160 [130 - 180] 分钟，< 0.0001），辐射暴露更低（932.5 [625 - 1716] μGy vs. 2445 [1228 - 4791] μGy，< 0.0001）以及RF应用次数更少（71 [54.8 - 83.8] 次 vs. 103 [88.5 - 120.5] 次，< 0.0001）。未发生重大并发症。两组间6个月房颤复发率相当（21.2% vs. 33.3%，= 0.15）。
在接受高功率、短持续时间房颤RFCA的患者中，使用GA与更好的手术效率相关，同时早期复发率与MCS相当。
