{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:37:42Z","timestamp":1787960262459,"version":"build-2784847793"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":58,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Pulsed field ablation for atrial fibrillation offers shorter procedural times and improved safety compared with thermal ablation, but the optimal anaesthesia strategy remains uncertain. Most centres in the USA use general anaesthesia with endotracheal intubation, whereas monitored anaesthesia care without endotracheal intubation may be a safe and efficient alternative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare procedural efficiency and safety between monitored anaesthesia care and general anaesthesia for pulsed field ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Consecutive adults who underwent pulsed field ablation for atrial fibrillation between 2024 and 2025 at Marshfield Clinic Health System were included. The anaesthesia approach was determined by operator preference. Procedural times, medication use, complications, and patient tolerance were recorded prospectively. Among 200 patients, 100 received monitored anaesthesia care without endotracheal intubation, and 100 received general anaesthesia. The mean age was 67 years, 42% were female, and the mean body mass index was 33 kilograms per square metre. Monitored anaesthesia care shortened case duration (77 vs. 95\u2005min; P &amp;lt; 0.001) and laboratory time (118 vs. 153\u2005min; P = 0.002) and required fewer adjunct medications (P &amp;lt; 0.001). Twenty-five procedures (25%) were challenging due to cough or motion but were all completed safely. Complications occurred in one monitored anaesthesia care case and six general anaesthesia cases (P = 0.054). Pulmonary vein isolation was achieved in all patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Monitored anaesthesia care without endotracheal intubation was safe, efficient, and resource-sparing compared with general anaesthesia for pulsed field atrial fibrillation ablation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeag070","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T11:42:47Z","timestamp":1776944567000},"source":"Crossref","is-referenced-by-count":1,"title":["Monitored anaesthesia care without endotracheal intubation and general anaesthesia in pulsed field atrial fibrillation ablation"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9435-0145","authenticated-orcid":false,"given":"Weijia","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Marshfield Clinic Health System , 1000 N Oak Ave, Marshfield, WI 54449 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swecha","family":"Goel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Marshfield Clinic Health System , 1000 N Oak Ave, Marshfield, WI 54449 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan J","family":"Estrada","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Marshfield Clinic Health System , 1000 N Oak Ave, Marshfield, WI 54449 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7026-5739","authenticated-orcid":false,"given":"Elliot","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Marshfield Clinic Health System , 1000 N Oak Ave, Marshfield, WI 54449 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Obholz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Marshfield Clinic Health System , 1000 N Oak Ave, Marshfield, WI 54449 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiying","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mayo Clinic Health System , 700 West Ave S, La Crosse, WI 54601 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humberto J","family":"Vidaillet","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Marshfield Clinic Health System , 1000 N Oak Ave, Marshfield, WI 54449 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Marshfield Clinic Health System , Weston, WI 54476 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Param P","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Marshfield Clinic Health System , 1000 N Oak Ave, Marshfield, WI 54449 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"2026051509565921200_oeag070-B1","doi-asserted-by":"crossref","first-page":"3353","DOI":"10.1111\/jce.70102","article-title":"Trends in atrial fibrillation ablation utilization following 2022 CMS reimbursement reduction: a nationwide analysis","volume":"36","author":"Puri","year":"2025","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2026051509565921200_oeag070-B2","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1161\/CIRCULATIONAHA.123.063988","article-title":"Pulsed field ablation for the treatment of atrial fibrillation: PULSED AF pivotal trial","volume":"147","author":"Verma","year":"2023","journal-title":"Circulation"},{"key":"2026051509565921200_oeag070-B3","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1056\/NEJMoa2307291","article-title":"Pulsed field or conventional thermal ablation for paroxysmal atrial fibrillation","volume":"389","author":"Reddy","year":"2023","journal-title":"N Engl J Med"},{"key":"2026051509565921200_oeag070-B4","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1161\/CIRCULATIONAHA.125.074427","article-title":"COOPERATIVE-PFA: a three-arm randomized controlled trial","volume":"152","author":"Sochorov\u00e1","year":"2025","journal-title":"Circulation"},{"key":"2026051509565921200_oeag070-B5","doi-asserted-by":"crossref","first-page":"euad230","DOI":"10.1093\/europace\/euad230","article-title":"Sedation strategies for pulsed-field ablation of atrial fibrillation: focus on deep sedation with intravenous ketamine in spontaneous respiration","volume":"25","author":"Iacopino","year":"2023","journal-title":"Europace"},{"key":"2026051509565921200_oeag070-B6","doi-asserted-by":"crossref","first-page":"euae301","DOI":"10.1093\/europace\/euae301","article-title":"Comparative analysis of anaesthesia modalities in pulmonary vein isolation: insights from a prospective multicentre registry","volume":"27","author":"Massalha","year":"2025","journal-title":"Europace"},{"key":"2026051509565921200_oeag070-B7","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1097\/ALN.0000000000005052","article-title":"Closing the chasm: understanding and addressing the anesthesia workforce supply and demand imbalance","volume":"141","author":"Abouleish","year":"2024","journal-title":"Anesthesiology"},{"key":"2026051509565921200_oeag070-B8","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.hroo.2023.06.010","article-title":"Ablation of atrial fibrillation in an ambulatory outpatient setting","volume":"4","author":"Willcox","year":"2023","journal-title":"Heart Rhythm O2"},{"key":"2026051509565921200_oeag070-B9","doi-asserted-by":"crossref","first-page":"100048","DOI":"10.1016\/j.glmedi.2024.100048","article-title":"Anesthesiologist shortage in the United States: a call for action","volume":"2","author":"Menezes","year":"2024","journal-title":"J Med Surg Public Health"},{"key":"2026051509565921200_oeag070-B10","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.hrthm.2010.10.043","article-title":"General anesthesia reduces the prevalence of pulmonary vein reconnection during repeat ablation when compared with conscious sedation: results from a randomized study","volume":"8","author":"Di Biase","year":"2011","journal-title":"Heart Rhythm"},{"key":"2026051509565921200_oeag070-B11","doi-asserted-by":"crossref","first-page":"euaf287","DOI":"10.1093\/europace\/euaf287","article-title":"Characterization of sedation strategies in real-world use of pulsed field ablation sub-analysis of the EU-PORIA registry","author":"Chun","year":"2025","journal-title":"Europace"},{"key":"2026051509565921200_oeag070-B12","doi-asserted-by":"crossref","first-page":"euad234","DOI":"10.1093\/europace\/euad234","article-title":"Deep sedation for pulsed field ablation by electrophysiology staff: can and should we do it?","volume":"25","author":"Mulder","year":"2023","journal-title":"Europace"},{"key":"2026051509565921200_oeag070-B13","doi-asserted-by":"crossref","first-page":"euaf156","DOI":"10.1093\/europace\/euaf156","article-title":"Sedation vs. General anaesthesia in patients with atrial fibrillation undergoing catheter ablation: a systematic review and meta-analysis","volume":"27","author":"Ara\u00fajo","year":"2025","journal-title":"Europace"},{"key":"2026051509565921200_oeag070-B14","doi-asserted-by":"crossref","first-page":"euae270","DOI":"10.1093\/europace\/euae270","article-title":"General anaesthesia and deep sedation for monopolar pulsed field ablation using a lattice-tip catheter combined with a novel three-dimensional mapping system","volume":"26","author":"Rillig","year":"2024","journal-title":"Europace"},{"key":"2026051509565921200_oeag070-B15","doi-asserted-by":"crossref","first-page":"103095","DOI":"10.1016\/j.jaccas.2024.103095","article-title":"Laryngospasm during pulsed field ablation of the left superior pulmonary vein","volume":"30","author":"\u017buchowski","year":"2025","journal-title":"JACC Case Rep"}],"container-title":["European Heart Journal Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjopen\/advance-article-pdf\/doi\/10.1093\/ehjopen\/oeag070\/68172225\/oeag070.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/6\/2\/oeag070\/68172225\/oeag070.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/6\/2\/oeag070\/68172225\/oeag070.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T13:57:03Z","timestamp":1778853423000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjopen\/article\/doi\/10.1093\/ehjopen\/oeag070\/8663702"}},"subtitle":[],"editor":[{"given":"Frieder","family":"Braunschweig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3,5]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjopen\/oeag070","relation":{},"ISSN":["2752-4191"],"issn-type":[{"value":"2752-4191","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3]]},"article-number":"oeag070"}}