{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:07:53Z","timestamp":1781640473387,"version":"3.54.5"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Adequate sedation and analgesia are essential for catheter ablation of atrial fibrillation (AF) to ensure patient comfort and procedural safety. However, the availability of cardiac anaesthesiology is limited. This study evaluated the efficacy and safety of an operator-directed, nurse-administered (ODNA) sedation protocol using propofol and remifentanil during AF ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this prospective, single-centre observational cohort study, consecutive patients undergoing catheter ablation for AF from August 2023 to March 2024 were enrolled. Sedation-related adverse events and intra-procedural vital signs were recorded. Sedation depth was assessed using the Modified Observer\u2019s Alertness\/Sedation (MOAA\/S) scale, and patient satisfaction was evaluated using the Visual Analogue Scale (VAS). A total of 230 patients were included (mean age 61.9 years; 76.1% male). Of these, 7.4% had a body mass index of \u226530 kg\/m2, and 4.3% had obstructive sleep apnoea. Paroxysmal AF accounted for 30.9%, and the mean procedure time was 174 min. The primary outcome\u2014defined as unplanned sedation interruption, intubation, or continuous vasopressor requirement\u2014occurred in 2.2% of patients. Intermittent hypotension (mean arterial pressure: &amp;lt;60 mmHg) occurred in 36.1% of patients, but no patient required continuous vasopressors. The mean MOAA\/S score was 0.4 \u00b1 0.4. Post-procedural surveys showed high satisfaction (mean VAS: 8.8) and low maximal pain (VAS: 0.9).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An ODNA protocol using propofol and remifentanil provides effective and safe sedation for AF ablation, with high patient satisfaction and minimal serious adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjcn\/zvaf252","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T12:54:33Z","timestamp":1766580873000},"page":"573-580","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of operator-directed, nurse-administered propofol sedation in atrial fibrillation ablation"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8831-8344","authenticated-orcid":false,"given":"Jinsun","family":"Park","sequence":"first","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine , 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505 ,","place":["Republic of Korea"]},{"name":"Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Hanyang University College of Medicine , Seoul ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6180-0157","authenticated-orcid":false,"given":"Myung-Jin","family":"Cha","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine , 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9867-4991","authenticated-orcid":false,"given":"Min Soo","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine , 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4391-5406","authenticated-orcid":false,"given":"Gi-Byoung","family":"Nam","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine , 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9055-049X","authenticated-orcid":false,"given":"Kee-Joon","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine , 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3573-638X","authenticated-orcid":false,"given":"Jun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine , 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"2026061604523217700_zvaf252-B1","doi-asserted-by":"crossref","first-page":"100786","DOI":"10.1016\/j.lanepe.2023.100786","article-title":"Atrial fibrillation: epidemiology, screening and digital health","volume":"37","author":"Linz","year":"2024","journal-title":"Lancet Reg Health Eur"},{"key":"2026061604523217700_zvaf252-B2","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jacc.2023.08.017","article-title":"2023 ACC\/AHA\/ACCP\/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"83","author":"Joglar","year":"2024","journal-title":"J Am Coll Cardiol"},{"key":"2026061604523217700_zvaf252-B3","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS) Developed by the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC), with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Endorsed by the European Stroke Organisation (ESO)","volume":"45","author":"Van Gelder","year":"2024","journal-title":"Eur Heart J"},{"key":"2026061604523217700_zvaf252-B4","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1093\/europace\/euab154","article-title":"Worldwide sedation strategies for atrial fibrillation ablation: current status and evolution over the last decade","volume":"23","author":"Garcia","year":"2021","journal-title":"Europace"},{"key":"2026061604523217700_zvaf252-B5","doi-asserted-by":"crossref","first-page":"1124372","DOI":"10.1155\/2022\/1124372","article-title":"Comparison of the different anesthesia strategies for atrial fibrillation catheter ablation: a systematic review and meta-analysis","volume":"2022","author":"Pang","year":"2022","journal-title":"Cardiol Res Pract"},{"key":"2026061604523217700_zvaf252-B6","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":"2026061604523217700_zvaf252-B7","doi-asserted-by":"crossref","first-page":"865","DOI":"10.3390\/jpm14080865","article-title":"General anesthesia improves efficiency of high-power short-duration catheter ablation for atrial fibrillation: comparison with mild conscious sedation","volume":"14","author":"Minciuna","year":"2024","journal-title":"J Pers Med"},{"key":"2026061604523217700_zvaf252-B8","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1111\/pace.13928","article-title":"General anesthesia during atrial fibrillation ablation: standardized protocol and experience","volume":"43","author":"Osorio","year":"2020","journal-title":"Pacing Clin Electrophysiol"},{"key":"2026061604523217700_zvaf252-B9","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1213\/ANE.0000000000001009","article-title":"Target-controlled infusion: a mature technology","volume":"122","author":"Absalom","year":"2016","journal-title":"Anesth Analg"},{"key":"2026061604523217700_zvaf252-B10","first-page":"101","volume-title":"Miller's Anesthesia","author":"Hadler","year":"2020","edition":"9th edn"},{"key":"2026061604523217700_zvaf252-B11","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.hrthm.2021.12.028","article-title":"Dexmedetomidine versus propofol for operator-directed nurse-administered procedural sedation during catheter ablation of atrial fibrillation: a randomized controlled study","volume":"19","author":"Servatius","year":"2022","journal-title":"Heart Rhythm"},{"key":"2026061604523217700_zvaf252-B12","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1093\/europace\/eur328","article-title":"Propofol sedation administered by cardiologists without assisted ventilation for long cardiac interventions: an assessment of 1000 consecutive patients undergoing atrial fibrillation ablation","volume":"14","author":"Salukhe","year":"2012","journal-title":"Europace"},{"key":"2026061604523217700_zvaf252-B13","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.hrthm.2011.10.009","article-title":"A retrospective analysis of proceduralist-directed, nurse-administered propofol sedation for implantable cardioverter-defibrillator procedures","volume":"9","author":"Sayfo","year":"2012","journal-title":"Heart Rhythm"},{"key":"2026061604523217700_zvaf252-B14","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1093\/europace\/euv303","article-title":"Propofol sedation administered by cardiologists for patients undergoing catheter ablation for ventricular tachycardia","volume":"18","author":"Servatius","year":"2016","journal-title":"Europace"},{"key":"2026061604523217700_zvaf252-B15","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1111\/j.1365-2044.2007.05055.x","article-title":"Propofol infusion syndrome","volume":"62","author":"Kam","year":"2007","journal-title":"Anesthesia"},{"key":"2026061604523217700_zvaf252-B16","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1164\/ajrccm.153.3.8630539","article-title":"Sedation of critically ill patients during mechanical ventilation. A comparison of propofol and midazolam","volume":"153","author":"Kress","year":"1996","journal-title":"Am J Respir Crit Care Med"},{"key":"2026061604523217700_zvaf252-B17","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1056\/NEJMoa1707855","article-title":"Catheter ablation for atrial fibrillation with heart failure","volume":"378","author":"Marrouche","year":"2018","journal-title":"N Engl J Med"}],"container-title":["European Journal of Cardiovascular Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjcn\/advance-article-pdf\/doi\/10.1093\/eurjcn\/zvaf252\/66327838\/zvaf252.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjcn\/article-pdf\/25\/3\/573\/66327838\/zvaf252.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjcn\/article-pdf\/25\/3\/573\/66327838\/zvaf252.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T08:52:40Z","timestamp":1781599960000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjcn\/article\/25\/3\/573\/8418520"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,1]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2,1]]},"published-print":{"date-parts":[[2026,6,16]]}},"URL":"https:\/\/doi.org\/10.1093\/eurjcn\/zvaf252","relation":{},"ISSN":["1474-5151","1873-1953"],"issn-type":[{"value":"1474-5151","type":"print"},{"value":"1873-1953","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2026,2,1]]}}}