房顫消融術(shù)是治療房顫的重要手段之一。你們那房顫消融術(shù)是在什么麻醉下進(jìn)行的？看看發(fā)表在Europace雜志上的一篇調(diào)查，了解一下其他醫(yī)院是如何開展房顫消融麻醉的。房顫消融治療的全球鎮(zhèn)靜策略：過去十年的現(xiàn)狀和進(jìn)展心房顫動（房顫，atrialfi

房顫消融術(shù)是治療房顫的重要手段之一。你們那房顫消融術(shù)是在什么麻醉下進(jìn)行的？看看發(fā)表在Europace雜志上的一篇調(diào)查，了解一下其他醫(yī)院是如何開展房顫消融麻醉的。

房顫消融治療的全球鎮(zhèn)靜策略：過去十年的現(xiàn)狀和進(jìn)展

心房顫動（房顫，atrial fibrillation，AF）的導(dǎo)管消融治療已成為電生理實(shí)驗(yàn)室中最常見的手術(shù)之一，手術(shù)量迅速增加。房顫消融治療的圍術(shù)期麻醉因醫(yī)療單位而異，從全身麻醉到深度或清醒鎮(zhèn)靜。

這項調(diào)查的目的是評估目前世界范圍內(nèi)房顫消融治療的鎮(zhèn)靜實(shí)踐及其在過去十年中的進(jìn)展。

開展房顫消融治療的醫(yī)療單位對這一項在線調(diào)查做出了回應(yīng)。

共有297個醫(yī)療單位參加了調(diào)查。

總體而言，2010年至2019年間，房顫消融手術(shù)的中位數(shù)（四分位數(shù)）從91（43-200）增加到每年200（74-350）（P<0.001）。

冷凍消融的比例也從17.0%增加到33.2%（P<0.001）。

2019年，最常用的鎮(zhèn)靜技術(shù)是全身麻醉（40.5%），其次是清醒鎮(zhèn)靜（32.0%）和深度鎮(zhèn)靜（27.5%）。

2010年至2019年間，在全身麻醉下進(jìn)行手術(shù)（+4.4%；P=0.02）和深度鎮(zhèn)靜（+4.8%；P<0.01）有所增加，而清醒鎮(zhèn)靜的使用減少（-9.2%；P<0.001）。

最常用的鎮(zhèn)靜藥物是異丙酚和咪唑安定，而最常用的阿片類藥物是瑞芬太尼和芬太尼。

這項世界范圍的調(diào)查顯示，房顫消融手術(shù)的數(shù)量在過去十年中翻了一番多，全身麻醉仍然是最常用的。需要對不同鎮(zhèn)靜策略的結(jié)果進(jìn)行比較研究，以指導(dǎo)最佳決策。

關(guān)鍵詞：心房顫動；清醒鎮(zhèn)靜；冷凍消融；深度鎮(zhèn)靜；EHRA調(diào)查；全身麻醉；鎮(zhèn)靜。

重點(diǎn)詞匯釋義

sedation藥物鎮(zhèn)靜; 鎮(zhèn)靜狀態(tài)

atrial fibrillation心房纖顫

become one成為一體，結(jié)合

electrophysiology電生理學(xué)；電生理現(xiàn)象

between centres中心間；軸間

interquartile range四分位差

原文摘要

Worldwide sedation strategies for atrial fibrillation ablation: current status and evolution over the last decade

Catheter ablation for atrial fibrillation (AF) has become one of the most common procedures in the electrophysiology lab with rapidly increasing volumes. Peri-procedural anaesthesia for AF ablation varies between centres, from general anaesthesia to deep or conscious sedation. The aim of this survey was to assess current sedation practices for AF ablation worldwide and its evolution over the last decade. Centres regularly performing AF ablation responded to an online survey. A total of 297 centres participated in the survey. Overall, the median (interquartile range) number of AF ablation procedures increased from 91 (43-200) to 200 (74-350) per year (P < 0.001) between 2010 and 2019. The proportion of cryoablation also increased from 17.0% to 33.2% (P < 0.001). In 2019, the most used sedation technique was general anaesthesia (40.5%), followed by conscious sedation (32.0%) and deep sedation (27.5%). Between 2010 and 2019, the proportion of procedures performed under general anaesthesia (+4.4%; P = 0.02) and deep sedation (+4.8%; P < 0.01) increased, whereas the use of conscious sedation decreased (-9.2%; P < 0.001). The most commonly used hypnotic drugs were propofol and midazolam, whereas the most commonly used opioid drugs were remifentanyl and fentanyl. This worldwide survey shows that the number of AF ablation procedures has more than doubled over the last decade and general anaesthesia remains most commonly used. Studies comparing outcomes between different sedation strategies are needed to guide optimal decision-making.

Keywords: Atrial fibrillation; Conscious sedation; Cryoablation; Deep sedation; EHRA survey; General anaesthesia; Sedation.