General anesthesia is not superior to sedation in clinical outcome and cost-effectiveness for ablation of persistent atrial fibrillation

Abstract

Background: The strategy of anesthesia used during ablation of atrial fibrillation (AF) remains controversial. This study aimed to compare sedation with general anesthesia (GA) for catheter ablation of AF. Hypothesis: The presence of AF is associated with an increased risk of stroke and heart failure and decreased quality of life and survival. Methods: We carried out a retrospective single-centered study with 351 patients undergoing the first ablation procedure for AF under sedation or GA. The main outcome was freedom from recurrence of AF at 1 year. The total time of staying at the ablation laboratory and procedure cost were also calculated. Results: Freedom from atrial arrhythmia and ablation time did not differ between AF patients under sedation and GA (77.9% vs 79.9% and 42.27 ± 9.84 minutes vs 41.51 ± 9.27 minutes, respectively), while the total procedure time and cost were lower in patients who underwent sedation than GA (171.39 ± 45.09 minutes vs 202.92 ± 43.85 and 8.00 ± 7.02 CNY vs 8.79 ± 11.63 CNY, respectively). Conclusion: GA is not superior to sedation, in terms of ablation time and freedom from atrial arrhythmia at 1 year, whereas patients with GA had more anesthesia time and procedure cost than sedation.