{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:17:12Z","timestamp":1793053032121,"version":"4.5.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pulsed field ablation (PFA) is a novel, largely nonthermal ablative modality that, by virtue of its putative preferential action on myocardial tissue through the process of irreversible electroporation (IRE), may replace conventional thermal ablation for atrial fibrillation (AF). The recent inspIRE study confirmed safety and effectiveness of a fully integrated biphasic PFA system with a variable loop circular catheter for the treatment of paroxysmal AF. The majority of PFA procedures were performed using general anesthesia. However, due to the risks of general anesthesia we report the data regarding our sedation protocol used during inspIRE study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A total of 29 patients (mean age 55\u00b19 years; 72% male) were enrolled as part of this analysis within the inspIRE trial. The sedation protocol is reported in the manuscript. The Richmond Agitation-Sedation Scale (RASS), the Visual Analogue Scale (VAS) and the Patient State Index were collected during sedation. Each patient was monitored using the Masimo Sedline. At the end of ablation, the Likert Scale Questionnaire (LSQ) was used to assess the patients' satisfaction with intraoperative analgesia-sedation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>No procedural complications were documented. Sufficient oxygen saturation was maintained in all patients during procedure. Non-invasive ventilation or tracheal intubation were not required for any patient. The RAAS score between -1 to -5 was obtained in 27 patients (93%) while the value 0 was obtained in 2 patients (7%). The VAS score between 0 to 2 was obtained in 24 patients (83%); the VAS score 3 in 3 patients (10%) and the VAS score 4 in 2 patients (7%). The PSI score &amp;lt;50 was achieved in 16 patients (55%) while the PSI between 50 and 70 was achieved in 9 patients (31%). Positive answers to LSQ were obtained in most patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>During PFA ablation procedures with the variable-loop circular catheter and its accompanying biphasic pulse, our deep sedation protocol is a valid alternative to general anesthesia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euad222","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T15:08:12Z","timestamp":1689865692000},"source":"Crossref","is-referenced-by-count":50,"title":["Deep sedation protocol during atrial fibrillation ablation using a novel variable-loop biphasic pulsed field ablation catheter"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9347-8884","authenticated-orcid":false,"given":"Massimo","family":"Grimaldi","sequence":"first","affiliation":[{"name":"Dipartimento di Cardiologia, Ospedale Generale Regionale \u2018F. Miulli\u2019 , Acquaviva delle Fonti, Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4485-326X","authenticated-orcid":false,"given":"Federico","family":"Quadrini","sequence":"additional","affiliation":[{"name":"Dipartimento di Cardiologia, Ospedale Generale Regionale \u2018F. Miulli\u2019 , Acquaviva delle Fonti, Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Caporusso","sequence":"additional","affiliation":[{"name":"Reparto di Anestesia e Rianimazione, Ospedale Generale Regionale \u2018F. Miulli\u2019 , Acquaviva delle Fonti, Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4133-2664","authenticated-orcid":false,"given":"Federica","family":"Troisi","sequence":"additional","affiliation":[{"name":"Dipartimento di Cardiologia, Ospedale Generale Regionale \u2018F. Miulli\u2019 , Acquaviva delle Fonti, Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Vitulano","sequence":"additional","affiliation":[{"name":"Dipartimento di Cardiologia, Ospedale Generale Regionale \u2018F. Miulli\u2019 , Acquaviva delle Fonti, Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Delmonte","sequence":"additional","affiliation":[{"name":"Reparto di Anestesia e Rianimazione, Ospedale Generale Regionale \u2018F. Miulli\u2019 , Acquaviva delle Fonti, Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-2056","authenticated-orcid":false,"given":"Antonio","family":"Di Monaco","sequence":"additional","affiliation":[{"name":"Dipartimento di Cardiologia, Ospedale Generale Regionale \u2018F. Miulli\u2019 , Acquaviva delle Fonti, Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,20]]},"reference":[{"key":"2023081716020467300_euad222-B1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1093\/europace\/eux275","article-title":"2017 HRS\/EHRA\/EACS\/APHRS\/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation","volume":"20","author":"Calkins","year":"2018","journal-title":"Europace"},{"key":"2023081716020467300_euad222-B2","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":"2023081716020467300_euad222-B3","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":"2023081716020467300_euad222-B4","first-page":"94","article-title":"Pulsed field ablation to treat atrial fibrillation: a review of the literature","volume":"9","author":"Di Monaco","year":"2022","journal-title":"J Cardiovasc Dev Dis"},{"key":"2023081716020467300_euad222-B5","doi-asserted-by":"crossref","first-page":"e010661","DOI":"10.1161\/CIRCEP.121.010661","article-title":"Time course of irreversible electroporation lesion development through short- and long-term follow-up in pulsed-field ablation-treated hearts","volume":"15","author":"Grimaldi","year":"2022","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2023081716020467300_euad222-B6","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1093\/europace\/euac191","article-title":"Differential effect of high-frequency electroporation on myocardium vs. non-myocardial tissues","volume":"25","author":"Moshkovits","year":"2023","journal-title":"Europace"},{"key":"2023081716020467300_euad222-B7","doi-asserted-by":"crossref","first-page":"ii44","DOI":"10.1093\/europace\/euab258","article-title":"New energy sources and technologies for atrial fibrillation catheter ablation","volume":"24","author":"Boersma","year":"2022","journal-title":"Europace"},{"key":"2023081716020467300_euad222-B8","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1093\/europace\/euac050","article-title":"Multi-national survey on the methods, efficacy, and safety on the post-approval clinical use of pulsed field ablation (MANIFEST-PF)","volume":"24","author":"Ekanem","year":"2022","journal-title":"Europace"},{"key":"2023081716020467300_euad222-B9","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1093\/europace\/euac033","article-title":"Cardiac ablation with pulsed electric fields: principles and biophysics","volume":"24","author":"Sugrue","year":"2022","journal-title":"Europace"},{"key":"2023081716020467300_euad222-B10","doi-asserted-by":"crossref","first-page":"e011780","DOI":"10.1161\/CIRCEP.122.011780","article-title":"Paroxysmal AF ablation using a novel variable-loop biphasic pulsed field ablation catheter integrated with a 3D mapping system: 1-year outcomes of the multicenter inspIRE study","volume":"16","author":"Duytschaever","year":"2023","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2023081716020467300_euad222-B11","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1164\/rccm.2107138","article-title":"The Richmond agitation\u2013sedation scale validity and reliability in adult intensive care unit patients","volume":"166","author":"Sessler","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"key":"2023081716020467300_euad222-B12","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.bpa.2005.07.008","article-title":"Patient state index","volume":"20","author":"Drover","year":"2006","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"2023081716020467300_euad222-B13","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.3758\/s13428-018-1041-8","article-title":"The visual analogue scale for rating, ranking and paired-comparison (VAS-RRP): a new technique for psychological measurement","volume":"50","author":"Sung","year":"2018","journal-title":"Behav Res Methods"},{"key":"2023081716020467300_euad222-B14","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.3758\/s13428-016-0850-x","article-title":"Investigating measurement equivalence of visual analogue scales and Likert-type scales in internet-based personality questionnaires","volume":"49","author":"Kuhlmann","year":"2017","journal-title":"Behav Res Methods"},{"key":"2023081716020467300_euad222-B15","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1111\/jce.15813","article-title":"Effect of contact force on pulsed field ablation lesions in porcine cardiac tissue","volume":"34","author":"Mattison","year":"2023","journal-title":"J Cardiovasc Electrophysiol"}],"container-title":["Europace"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/europace\/advance-article-pdf\/doi\/10.1093\/europace\/euad222\/50915570\/euad222.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/25\/9\/euad222\/51140707\/euad222.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/25\/9\/euad222\/51140707\/euad222.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T17:03:55Z","timestamp":1692291835000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/doi\/10.1093\/europace\/euad222\/7226768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,20]]},"references-count":15,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,8,2]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euad222","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,9]]},"published":{"date-parts":[[2023,7,20]]},"article-number":"euad222"}}