The Practice of Deep Sedation in Electrophysiology and Cardiac Pacing Laboratories: Results of an Italian Survey Promoted by the AIAC (Italian Association of Arrhythmology and Cardiac Pacing).
Pietro PalmisanoMatteo ZiacchiAndrea AngelettiFederico GuerraGiovanni Battista ForleoMatteo BertiniPasquale NotarstefanoMichele AccogliCarlo LavalleGiovanni BisignaniMaurizio LandolinaGabriele ZanottoAntonio D'OnofrioRenato Pietro RicciRoberto De PontiGiuseppe BorianiPublished in: Journal of clinical medicine (2021)
The aim of this survey, which was open to all Italian cardiologists involved in arrhythmia, was to assess common practice regarding sedation and analgesia in interventional electrophysiology procedures in Italy. The survey consisted of 28 questions regarding the approach to sedation used for elective direct-current cardioversion (DCC), subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation, atrial fibrillation (AF) ablation, ventricular tachycardia (VT) ablation, and transvenous lead extraction procedures. A total of 105 cardiologists from 92 Italian centres took part in the survey. The rate of centres where DCC, S-ICD implantation, AF ablation, VT ablation and lead extraction procedures were performed without anaesthesiologic assistance was 60.9%, 23.6%, 51.2%, 37.3%, and 66.7%, respectively. When these procedures were performed without anaesthesiologic assistance, the drugs (in addition to local anaesthetics) commonly administered were benzodiazepines (from 64.3% to 79.6%), opioids (from 74.4% to 88.1%), and general anaesthetics (from 7.1% to 30.4%). Twenty-three (21.9%) of the 105 cardiologists declared that they routinely administered propofol, without the supervision of an anaesthesiologist, in at least one of the above-mentioned procedures. In current Italian clinical practice, there is a lack of uniformity in the sedation/analgesia approach used in interventional electrophysiology procedures.
Keyphrases
- atrial fibrillation
- catheter ablation
- cross sectional
- primary care
- healthcare
- mechanical ventilation
- pain management
- left atrial
- clinical practice
- left ventricular
- radiofrequency ablation
- heart failure
- chronic pain
- oral anticoagulants
- left atrial appendage
- patients undergoing
- ultrasound guided
- percutaneous coronary intervention
- coronary artery disease
- cardiac resynchronization therapy
- acute coronary syndrome
- acute respiratory distress syndrome
- extracorporeal membrane oxygenation