Characterization of sedation strategies in real-world use of pulsed field ablation Sub-analysis of the EU-PORIA registry. Article Swipe

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Chun, Kyoung Ryul Julian , Plank, Karin , Neven, Kars , Reichlin Tobias , Blaauw, Yuri , Hansen Jim , Adelino, Raquel , Ouss, Alexandre , Bordignon Stefano , Füting, Anna , Roten, Laurent , Mulder, Bart A , Ruwald, Martin H , Menè Roberto , van der Voort, Pepijn , Reinsch, Nico , Kueffer, Thomas , Boveda, Serge , Albrecht, Elizabeth M , Raybuck, Jonathan D , Wehrenberg, Scott , Sutton, Brad S , Schmidt, Boris ·

YOU? · · 2025 · Open Access · · DOI: https://doi.org/10.48620/92496

Background With the introduction of pulsed field ablation (PFA) to treat atrial fibrillation (AF), there is interest in studying workflow and sedation strategies to optimize integration into clinical practice. This sub-analysis characterizes early real-world use of general anesthesia versus deep sedation during AF ablation using the pentaspline PFA catheter.Methods EU-PORIA is an all-comer AF registry enrolling consecutive patients at seven high-volume centers in Europe. Patients were treated based on institutional standard-of-care. During follow-up, any episode of atrial tachycardia (AT) or AF >30s was considered an arrhythmia recurrence.Results EU-PORIA enrolled 1233 patients, of which 250 (20%) and 983 (80%) cases were performed using general anesthesia and deep sedation, respectively. Patients treated with general anesthesia were more often male and non-paroxysmal AF. In the general anesthesia group, 72% received pulmonary vein isolation (PVI)-only versus 90% in the deep sedation group (p<0.01), and 3D mapping was used in 60% of general anesthesia and 27% of deep sedation cases (p<0.01). Procedure and fluoroscopy times were shorter with deep sedation (51[36-84] vs 75[60-90] min; 13[8-19] vs 19[15-26] min; p<0.01). There were no differences in the incidence of serious adverse events. At 1-year follow-up, 74.8% and 73.8% of patients in the general anesthesia and deep sedation groups, respectively, were free from recurrent AF/AT (p=0.87).Conclusion AF ablation using deep sedation with the pentaspline PFA catheter demonstrated a safety and efficacy profile consistent with procedures performed under general anesthesia. This characterization of real-world use warrants further evaluation to understand optimal sedation strategies with PFA technologies.

Related Topics

Radiofrequency Ablation

General Anaesthesia

Catheter

Fluoroscopy

Ventricular Tachycardia

Concepts

Sedation Medicine Anesthesia Ablation Atrial fibrillation Catheter ablation Pulmonary vein Tachycardia Cardiac Ablation Adverse effect Radiofrequency ablation Deep vein Surgery Atrial tachycardia General anaesthesia Cryoablation Remifentanil Catheter Fluoroscopy Ventricular tachycardia Local anesthesia

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Title: Characterization of sedation strategies in real-world use of pulsed field ablation Sub-analysis of the EU-PORIA registry.

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Publication year: 2025

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Publication date: 2025-11-17

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Authors: Chun, Kyoung Ryul Julian, Plank, Karin, Neven, Kars, Reichlin Tobias, Blaauw, Yuri, Hansen Jim, Adelino, Raquel, Ouss, Alexandre, Bordignon Stefano, Füting, Anna, Roten, Laurent, Mulder, Bart A, Ruwald, Martin H, Menè Roberto, van der Voort, Pepijn, Reinsch, Nico, Kueffer, Thomas, Boveda, Serge, Albrecht, Elizabeth M, Raybuck, Jonathan D, Wehrenberg, Scott, Sutton, Brad S, Schmidt, Boris

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Concepts: Sedation, Medicine, Anesthesia, Ablation, Atrial fibrillation, Catheter ablation, Pulmonary vein, Tachycardia, Cardiac Ablation, Adverse effect, Radiofrequency ablation, Deep vein, Surgery, Atrial tachycardia, General anaesthesia, Cryoablation, Remifentanil, Catheter, Fluoroscopy, Ventricular tachycardia, Local anesthesia

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abstract_inverted_index.with	110, 162, 213, 225, 244
abstract_inverted_index.(20%)	94
abstract_inverted_index.(80%)	97
abstract_inverted_index.(AF),	13
abstract_inverted_index.(PFA)	8
abstract_inverted_index.73.8%	190
abstract_inverted_index.74.8%	188
abstract_inverted_index.AF/AT	206
abstract_inverted_index.There	174
abstract_inverted_index.based	67
abstract_inverted_index.cases	98, 154
abstract_inverted_index.early	32
abstract_inverted_index.field	6
abstract_inverted_index.group	137
abstract_inverted_index.often	115
abstract_inverted_index.seven	59
abstract_inverted_index.there	14
abstract_inverted_index.times	159
abstract_inverted_index.treat	10
abstract_inverted_index.under	228
abstract_inverted_index.using	44, 101, 210
abstract_inverted_index.which	92
abstract_inverted_index.1-year	186
abstract_inverted_index.During	71
abstract_inverted_index.atrial	11, 76
abstract_inverted_index.during	41
abstract_inverted_index.group,	124
abstract_inverted_index.pulsed	5
abstract_inverted_index.safety	220
abstract_inverted_index.versus	38, 131
abstract_inverted_index.>30s	81
abstract_inverted_index.Europe.	63
abstract_inverted_index.adverse	183
abstract_inverted_index.centers	61
abstract_inverted_index.episode	74
abstract_inverted_index.events.	184
abstract_inverted_index.further	237
abstract_inverted_index.general	36, 102, 111, 122, 147, 195, 229
abstract_inverted_index.groups,	200
abstract_inverted_index.mapping	141
abstract_inverted_index.optimal	241
abstract_inverted_index.profile	223
abstract_inverted_index.serious	182
abstract_inverted_index.shorter	161
abstract_inverted_index.treated	66, 109
abstract_inverted_index.13[8-19]	169
abstract_inverted_index.EU-PORIA	49, 87
abstract_inverted_index.Patients	64, 108
abstract_inverted_index.ablation	7, 43, 209
abstract_inverted_index.catheter	217
abstract_inverted_index.clinical	27
abstract_inverted_index.efficacy	222
abstract_inverted_index.enrolled	88
abstract_inverted_index.interest	16
abstract_inverted_index.optimize	24
abstract_inverted_index.patients	57, 192
abstract_inverted_index.received	126
abstract_inverted_index.registry	54
abstract_inverted_index.sedation	21, 40, 136, 153, 164, 199, 212, 242
abstract_inverted_index.studying	18
abstract_inverted_index.warrants	236
abstract_inverted_index.workflow	19
abstract_inverted_index.19[15-26]	171
abstract_inverted_index.75[60-90]	167
abstract_inverted_index.Procedure	156
abstract_inverted_index.all-comer	52
abstract_inverted_index.enrolling	55
abstract_inverted_index.incidence	180
abstract_inverted_index.isolation	129
abstract_inverted_index.patients,	90
abstract_inverted_index.performed	100, 227
abstract_inverted_index.practice.	28
abstract_inverted_index.pulmonary	127
abstract_inverted_index.recurrent	205
abstract_inverted_index.sedation,	106
abstract_inverted_index.(51[36-84]	165
abstract_inverted_index.(PVI)-only	130
abstract_inverted_index.Background	0
abstract_inverted_index.anesthesia	37, 103, 112, 123, 148, 196
abstract_inverted_index.arrhythmia	85
abstract_inverted_index.considered	83
abstract_inverted_index.consistent	224
abstract_inverted_index.evaluation	238
abstract_inverted_index.follow-up,	72, 187
abstract_inverted_index.procedures	226
abstract_inverted_index.real-world	33, 234
abstract_inverted_index.strategies	22, 243
abstract_inverted_index.understand	240
abstract_inverted_index.anesthesia.	230
abstract_inverted_index.consecutive	56
abstract_inverted_index.differences	177
abstract_inverted_index.fluoroscopy	158
abstract_inverted_index.high-volume	60
abstract_inverted_index.integration	25
abstract_inverted_index.p<0.01).	173
abstract_inverted_index.pentaspline	46, 215
abstract_inverted_index.tachycardia	77
abstract_inverted_index.(p<0.01),	138
abstract_inverted_index.(p<0.01).	155
abstract_inverted_index.demonstrated	218
abstract_inverted_index.fibrillation	12
abstract_inverted_index.introduction	3
abstract_inverted_index.sub-analysis	30
abstract_inverted_index.characterizes	31
abstract_inverted_index.institutional	69
abstract_inverted_index.respectively,	201
abstract_inverted_index.respectively.	107
abstract_inverted_index.technologies.	246
abstract_inverted_index.non-paroxysmal	118
abstract_inverted_index.catheter.Methods	48
abstract_inverted_index.characterization	232
abstract_inverted_index.standard-of-care.	70
abstract_inverted_index.recurrence.Results	86
abstract_inverted_index.(p=0.87).Conclusion	207
cited_by_percentile_year
countries_distinct_count	0
institutions_distinct_count	23
citation_normalized_percentile.value	0.79513503
citation_normalized_percentile.is_in_top_1_percent	False
citation_normalized_percentile.is_in_top_10_percent	False