Abstract 15469: Procedural Sedation With Dexmedetomidine During Ablation of Atrial Fibrillation: A Randomized Controlled Trial
Introduction: Procedural sedation by non-anesthesiologists with GABAergic anesthetics has the potential risk of fatal respiratory depression. Dexmedetomidine works its sedative action via α2-adrenergic receptors, and is less associated with respiratory depression. We tested the usability of dexmedetomidine as a procedural sedative during ablation of atrial fibrillation (AF).
Methods: Consecutive patients were randomized to be treated with dexmedetomidine (n = 43) or thiamylal (n = 44) as sedatives during AF ablation. Apneic and body movement events were monitored using a novel portable respiratory monitor, the SD-101, during the procedure.
Results: The respiratory disturbance index (RDI) defined as the total number of sleep-disordered breathing events divided by the recording time (10.4 ± 5.1 vs. 18.2 ± 8.1 events/h; p <0.0001) and movement index defined as the number of body movement events per hour (7.6 ± 6.1 vs. 11.0 ± 5.5 events/h; p = 0.0098) were both significantly lower in dexmedetomidine arm than in the thiamylal arm. A multivariate linear regression analysis including potential factors revealed that dexmedetomidine versus thiamylal was solely and independently associated with the RDI (β = -0.62; p = 0.0031). The occurrence of hypotension (3 [7%] and 2 [5%]; p = 0.68) and bradycardia (5 [12%] vs. 6 [14%]; p = 0.99) were similar in the patients with dexmedetomidine and thiamylal.
Conclusions: Procedural sedation with dexmedetomidine may assure safety and patient immobility during AF ablation, and therefore may be a potential alternative for that with GABAergic anesthetics.
- © 2013 by American Heart Association, Inc.