房颤消融术是治疗房颤的重要手段之一。你们那房颤消融术是在什么麻醉下进行的？看看发表在Europace杂志上的一篇调查，了解一下其他医院是如何开展房颤消融麻醉的。

房颤消融治疗的全球镇静策略：过去十年的现状和进展

心房颤动（房颤，atrial fibrillation，AF）的导管消融治疗已成为电生理实验室中最常见的手术之一，手术量迅速增加。房颤消融治疗的围术期麻醉因医疗单位而异，从全身麻醉到深度或清醒镇静。

这项调查的目的是评估目前世界范围内房颤消融治疗的镇静实践及其在过去十年中的进展。

开展房颤消融治疗的医疗单位对这一项在线调查做出了回应。

共有297个医疗单位参加了调查。

总体而言，2010年至2019年间，房颤消融手术的中位数（四分位数）从91（43-200）增加到每年200（74-350）（P<0.001）。

冷冻消融的比例也从17.0%增加到33.2%（P<0.001）。

2019年，最常用的镇静技术是全身麻醉（40.5%），其次是清醒镇静（32.0%）和深度镇静（27.5%）。

2010年至2019年间，在全身麻醉下进行手术（+4.4%；P=0.02）和深度镇静（+4.8%；P<0.01）有所增加，而清醒镇静的使用减少（-9.2%；P<0.001）。

最常用的镇静药物是异丙酚和咪唑安定，而最常用的阿片类药物是瑞芬太尼和芬太尼。

这项世界范围的调查显示，房颤消融手术的数量在过去十年中翻了一番多，全身麻醉仍然是最常用的。需要对不同镇静策略的结果进行比较研究，以指导最佳决策。

关键词：心房颤动；清醒镇静；冷冻消融；深度镇静；EHRA调查；全身麻醉；镇静。

重点词汇释义

sedation药物镇静; 镇静状态

atrial fibrillation心房纤颤

become one成为一体，结合

electrophysiology电生理学；电生理现象

between centres中心间；轴间

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.