Impact of General Anesthesia on Ablation Catheter Stability During Pulmonary Vein Isolation: An Assessment based on a Novel Measurement Approach

Abstract

Abstract Catheter ablation for atrial fibrillation (AF), during pulmonary vein isolation (PVI), is performed under general anesthesia (GA) or conscious sedation (CS). GA during PVI may improve treatment outcomes, via improving catheter stability. However, the improvement in catheter stability with GA compared to that with CS is unclear. Therefore, we aimed to verify the influence of GA on ablation catheter stability during PVI compared with that of CS by directly assessing catheter movement. Patients who underwent initial ablation using the EnSite Precision™ mapping system were recruited. The patients were divided into two groups (GA group or CS group), and the ablation catheter stability during PVI by the distance traveled by the catheter distal tip per second, clinical periprocedural characteristics, and periprocedural complications was compared. Among 69 consecutive patients, data from 30 patients (17 patients in the GA group and 13 patients in the CS group) and the distance traveled per second on 148,976 points/patient were evaluated. The GA group had a significantly smaller catheter tip travel distance than the CS group (0.92 (0.82‒1.16 vs. 1.25 (1.14‒1.38), p = 0.01). Therefore, GA during PVI for AF provides greater catheter stability than CS, which may contribute to more accessible and safer PVI procedures.