Curative ablation of atrial fibrillation: comparison between deep sedation and general anesthesia.
OBJECTIVE
To compare deep sedation with general anesthesia for curative ablation of atrial fibrillation.


METHODS
We conducted a prospective, randomized study with 32 patients, aged between 18 and 65 years, ASA 2 and 3, BMI d" 30 kg/m2, divided into two groups: deep sedation (G1) and general anesthesia (G2). All patients received intravenous midazolam (0.5 mg / kg). G1 received propofol (1mg/kg) and O2 by facemask, followed by continuous infusion of propofol (25-50mg/kg/min) and remifentanil (0.01-0.05 mg / kg / min). G2 received propofol (2mg/kg) and laryngeal mask with built-in drain tube, followed by continuous infusion of propofol (60-100mg/kg/min) and remifentanil (0.06 to 0.1g/kg/min). We compared heart rate, invasive blood pressure, arterial blood gases, complications and recurrence (outcome) in three months.


RESULTS
G1 patients had arterial blood gas with higher PaCO2 levels and lower pH (p = 0.001) and higher incidence of cough. There was a decrease in Mean Arterial Pressure (MAP) and Heart Rate (HR) in G2. Except cough, complications and recurrence were similar in both groups.


CONCLUSIONS
Both techniques can be used for the curative ablation of atrial fibrillation. General anesthesia provided smaller respiratory changes and greater immobility of the patient.
Post-Graduate Program in Surgical Sciences, Department of Surgery, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro – RJ, Brazil. bessadaspf@superig.com.br
Elizabeth Bessadas Penna
EB
Firme
Ismar Lima
IL
Cavalcanti
Louis
L
Barrucand
Alexandra Rezende
AR
Assad
Nubia Verçosa
NV
Figueiredo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D054810:Deep Sedation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult