Background: A novel lattice tip ablation catheter that can toggle between radiofrequency and pulsed-field energy is able to perform not only pulmonary vein isolation, but also linear lesions under general anesthesia (GA).
Objective: We aimed to evaluate the concerns associated with the use of deep sedation and the clinical data related to linear ablation.
Methods: Clinical data from two Germany high-volume atrial fibrillation (AF) centers were collected. The objectives of this study are to confirm the feasibility and safety of linear lesion ablation using the lattice tip catheter without GA. Acute procedural and short-term follow-up data were collected.
Results: This study included 55 patients who underwent AF ablation (15 with GA vs 40 with deep sedation) including linear lesion ablation for atrial tachyarrhythmia using a lattice tip catheter. Bidirectional block of linear lesions was achieved in 21 of 21 linear lesions in the GA and in 74 of 76 (97%) linear lesions in the deep sedation group (P = 1.000) including roof line in 41 of 41 (100%), posterior wall isolation in 4 of 4 (100%), anterior mitral isthmus (MI) line in 5 of 5 (100%) vs 24 of 25 (96%), posterior MI line in 1 of 1 (100%) vs 4 of 5 (80%), cavotricuspid isthmus line in 15 of 15 (100%), and 1 left atrial appendage isolation. The overall incidence rate of complications was 1.8% (1 cardiac tamponade). There was no other procedural related complication.
Conclusion: This preliminary clinical study demonstrates feasibility and safety of bidirectional block of linear lesions using a lattice tip catheter under deep sedation. Need to toggle between energy sources was low.
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http://dx.doi.org/10.1016/j.hrthm.2024.11.023 | DOI Listing |
Pediatr Qual Saf
December 2024
From the Division of Neonatology, Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, Pa.
Introduction: Although associated with respiratory morbidity, elective endotracheal intubation (ETI) for laser photocoagulation for retinopathy of prematurity (ROP) is the standard practice at our institution, with 100% of patients undergoing preoperation ETI. To mitigate this risk, we strove to reduce the percentage of infants intubated for laser photocoagulation by 30% by June 2022.
Methods: We assembled a multidisciplinary team and implemented a deep sedation guideline utilizing dexmedetomidine, fentanyl, and midazolam with noninvasive ventilation support for laser photocoagulation in January 2020.
Eur J Emerg Med
December 2024
Emergency Department, Azienda Sanitaria Locale Torino 3 (ASL TO3) Ospedale E. Agnelli, Pinerolo.
Background And Importance: Effective and safe procedural sedation is pivotal for the quality of care in the emergency department (ED).
Objectives: The aim of this work is to evaluate the feasibility, effectiveness, and safety procedural sedation performed by emergency physicians in the ED setting in Italy.
Design/setting And Participants/intervention: Following a specific training of the staff and with the adoption of a standardized protocol, a registry of procedural sedations performed on adult patients in 10 Italian EDs was compiled from 2019 to 2022; the following basic data were recorded: demographic and clinical information, procedure's indication, administered drugs, predefined, and actual sedation level.
Objective: Previous studies have reported that the noise generated by dental equipment can interfere with the auscultation of respiratory sounds during sedation. Therefore, this study aimed to identify whether positing the acoustic sensor on the chest or cervical position would be least susceptible to interference from dental suction device noise, a prominent noise noted during respiratory sound monitoring during dental sedation.
Methods: This prospective cohort study was conducted with 30 students.
Dig Liver Dis
December 2024
Hospital Universitario del Tajo, Critical Care, Department, Universidad Alfonso X el Sabio, Spain. Electronic address:
Background: Gastrointestinal endoscopy is increasingly performed under sedation in older patients. Aging has implications in increasing the morbidity and the risk of complications related to sedation. The aim of this study is to assess the difference in complications between patients aged 65 to 74 years and those aged over 75 years.
View Article and Find Full Text PDFAAPS J
December 2024
Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China.
NH600001 is a new general anaesthetic drug with a structure similar to etomidate. The objective of this study was to investigate the relationship between concentrations of NH600001 and sedation efficacy based on data from phase I-II studies and factors influencing the pharmacokinetics and pharmacodynamics of NH600001. The dataset consisted of 2 phase I studies in healthy subjects and 1 phase II study in patients undergoing gastroscopy.
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