Pulmonary Vein Isolation: Patient Experience under Conscious Sedation versus Anaesthesia

Abstract

Aim
Radiofrequency pulmonary vein isolation is an established treatment for atrial fibrillation. Patients are administered either conscious sedation or general anaesthesia. The purpose of this study was to compare patient experiences of conscious sedation versus general anaesthesia during pulmonary vein isolation.

Methods
A retrospective, observational, single-centre, single-operator study was performed, comparing patient experiences of pulmonary vein isolation performed under general anaesthesia versus conscious sedation. A Likert scale questionnaire was used to compare satisfaction with the different modes of anaesthesia, with score of 1 denoted for very dissatisfied and score of 5 for very satisfied.

Results
41 patients were included — 20 (48.8%) in conscious sedation group, and 21 (51.2%) in general anaesthesia group. Groups were well-matched as regards age (mean 56.3 +/-13.7yrs), gender (71.4% male), percentage with paroxysmal atrial fibrillation (76.2%), and percentage re-do cases (28.6%). Patients in the general anaesthesia group experienced lower levels of pain/discomfort (mean score 2.90 +/- 1.77 vs 1.33+/-0.80) (p<0.001) and were more likely to recommend the mode of anaesthesia (mean score 4.90 +/- 0.44 vs. 3.40 +/- 1.70) (p<0.001), compared with those in conscious sedation group. There was no significant difference in anxiety/depression post-procedure (p= 0.057), satisfaction with recovery time post procedure (p=0.175), likelihood to recommend the procedure (p= 0.103), and overall satisfaction with the ablation experience (p=0.089).

Discussion
Patients who had general anaesthesia for radiofrequency pulmonary vein isolation experienced less peri-procedural pain than patients who had conscious sedation and were more likely to recommend general anaesthesia as a mode of anaesthesia.