{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:46:58Z","timestamp":1791488818822,"version":"4.3.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Department of Cardiology Herlev-Gentofte University Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Catheter ablation (CA) is a well-established treatment option for atrial fibrillation (AF), where sedation and analgesia are pivotal for patient comfort and lesion formation. The impact of anaesthesia type on AF recurrence rates remains uncertain. This study aimed to examine AF recurrence rates depending on conscious sedation (CS) vs. general anaesthesia (GA) during CA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Utilizing nationwide data from the Danish healthcare registries, we conducted this cohort study involving adults (\u226518 years) undergoing first-time CA for AF between 2010 and 2018. Patients were categorized by anaesthesia type (CS or GA), with the primary endpoint being AF recurrence, defined by a composite endpoint of either antiarrhythmic drug (AAD) prescriptions, AF-related hospital admissions, electrical cardioversions, or AF re-ablation. The impact of anaesthesia type was evaluated using multivariable Cox proportional hazards analysis. The study cohort comprised 7957 (6421 CS and 1536 GA) patients. Persistent AF, hypertension, and heart failure, as well as use of AAD, were more prevalent in the GA group. Cumulative incidences of recurrent AF were higher in the CS group at 1 (46% vs. 37%) and at 5 (68% vs. 63%) years. Multivariate analysis revealed CS as significantly associated with increased risk of AF recurrence at 5-year follow-up [hazard ratio 1.26 (95% confidence interval 1.15\u20131.38)], consistent across paroxysmal and persistent AF subtypes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This nationwide cohort study suggests a higher risk of AF recurrence with CS during CA compared to GA. These results advocate for considering GA as the preferred anaesthesia type for improved CA outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euae203","type":"journal-article","created":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T03:37:48Z","timestamp":1723001868000},"source":"Crossref","is-referenced-by-count":20,"title":["General anaesthesia compared to conscious sedation for first-time atrial fibrillation catheter ablation\u2014a Danish nationwide cohort study"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0345-4345","authenticated-orcid":false,"given":"Lise Da","family":"Riis-Vestergaard","sequence":"first","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte University Hospital, University of Copenhagen , Gentofte Hospitalsvej 6, 2900 Hellerup ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-0774","authenticated-orcid":false,"given":"Jacob","family":"T\u00f8nnesen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte University Hospital, University of Copenhagen , Gentofte Hospitalsvej 6, 2900 Hellerup ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1541-309X","authenticated-orcid":false,"given":"Martin H","family":"Ruwald","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte University Hospital, University of Copenhagen , Gentofte Hospitalsvej 6, 2900 Hellerup ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8374-4202","authenticated-orcid":false,"given":"Christopher R","family":"Z\u00f6rner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte University Hospital, University of Copenhagen , Gentofte Hospitalsvej 6, 2900 Hellerup ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6763-3991","authenticated-orcid":false,"given":"Charlotte","family":"Middelfart","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte University Hospital, University of Copenhagen , Gentofte Hospitalsvej 6, 2900 Hellerup ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0928-5547","authenticated-orcid":false,"given":"Regitze","family":"Hein","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte University Hospital, University of Copenhagen , Gentofte Hospitalsvej 6, 2900 Hellerup ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0294-3750","authenticated-orcid":false,"given":"Arne","family":"Johannessen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte University Hospital, University of Copenhagen , Gentofte Hospitalsvej 6, 2900 Hellerup ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6600-9006","authenticated-orcid":false,"given":"Jim","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte University Hospital, University of Copenhagen , Gentofte Hospitalsvej 6, 2900 Hellerup ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9501-6168","authenticated-orcid":false,"given":"Rene Husted","family":"Worck","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte University Hospital, University of Copenhagen , Gentofte Hospitalsvej 6, 2900 Hellerup ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0548-402X","authenticated-orcid":false,"given":"Gunnar","family":"Gislason","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte University Hospital, University of Copenhagen , Gentofte Hospitalsvej 6, 2900 Hellerup ,","place":["Denmark"]},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen ,","place":["Denmark"]},{"name":"The Danish Heart Foundation , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten Lock","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte University Hospital, University of Copenhagen , Gentofte Hospitalsvej 6, 2900 Hellerup ,","place":["Denmark"]},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,8,6]]},"reference":[{"key":"2025021117521154700_euae203-B1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/1747493019897870","article-title":"Global epidemiology of atrial fibrillation: an increasing epidemic and public health challenge","volume":"16","author":"Lippi","year":"2021","journal-title":"Int J Stroke"},{"key":"2025021117521154700_euae203-B2","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.1161\/CIR.0000000000000659","article-title":"Heart disease and stroke statistics-2019 update: a report from the American Heart Association","volume":"139","author":"Benjamin","year":"2019","journal-title":"Circulation"},{"key":"2025021117521154700_euae203-B3","doi-asserted-by":"crossref","first-page":"3105","DOI":"10.1016\/j.jacc.2020.04.065","article-title":"Recurrence of atrial fibrillation after catheter ablation or antiarrhythmic drug therapy in the CABANA trial","volume":"75","author":"Poole","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2025021117521154700_euae203-B4","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1093\/europace\/euac055","article-title":"Influence of atrial fibrillation type on outcomes of ablation vs. drug therapy: results from CABANA","volume":"24","author":"Monahan","year":"2022","journal-title":"Europace"},{"key":"2025021117521154700_euae203-B5","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1093\/eurheartj\/ehx466","article-title":"Temporal trends in atrial fibrillation recurrence rates after ablation between 2005 and 2014: a nationwide Danish cohort study","volume":"39","author":"Pallisgaard","year":"2018","journal-title":"Eur Heart J"},{"key":"2025021117521154700_euae203-B6","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1007\/s00380-017-0961-z","article-title":"General anesthesia improves contact force and reduces gap formation in pulmonary vein isolation: a comparison with conscious sedation","volume":"32","author":"Chikata","year":"2017","journal-title":"Heart Vessels"},{"key":"2025021117521154700_euae203-B7","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":"2025021117521154700_euae203-B8","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/s10840-012-9672-7","article-title":"2012 HRS\/EHRA\/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design","volume":"33","author":"Calkins","year":"2012","journal-title":"J Interv Card Electrophysiol"},{"key":"2025021117521154700_euae203-B9","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur Heart J"},{"key":"2025021117521154700_euae203-B10","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":"2025021117521154700_euae203-B11","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1177\/1403494811401482","article-title":"The Danish National Patient Register","volume":"39","author":"Lynge","year":"2011","journal-title":"Scand J Public Health"},{"key":"2025021117521154700_euae203-B12","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1177\/1403494811399958","article-title":"The Danish register of causes of death","volume":"39","author":"Helweg-Larsen","year":"2011","journal-title":"Scand J Public Health"},{"key":"2025021117521154700_euae203-B13","doi-asserted-by":"crossref","first-page":"449","DOI":"10.2147\/CLEP.S91125","article-title":"The Danish national patient registry: a review of content, data quality, and research potential","volume":"7","author":"Schmidt","year":"2015","journal-title":"Clin Epidemiol"},{"key":"2025021117521154700_euae203-B14","doi-asserted-by":"crossref","first-page":"e012832","DOI":"10.1136\/bmjopen-2016-012832","article-title":"Positive predictive value of cardiovascular diagnoses in the Danish National Patient Registry: a validation study","volume":"6","author":"Sundb\u00f8ll","year":"20168","journal-title":"BMJ Open"},{"key":"2025021117521154700_euae203-B15","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1177\/1403494810394717","article-title":"The danish national prescription registry","volume":"39","author":"Kildemoes","year":"2011","journal-title":"Scand J Public Health"},{"key":"2025021117521154700_euae203-B16","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1080\/14017431.2022.2099009","article-title":"Validation of the national danish ablation database: a retrospective, registry-based validation study","volume":"56","author":"Lyng Lindgren","year":"2022","journal-title":"Scand Cardiovasc J"},{"key":"2025021117521154700_euae203-B17","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1093\/europace\/euac225","article-title":"Short- and long-term risk of atrial fibrillation recurrence after first time ablation according to body mass index: a nationwide Danish cohort study","volume":"25","author":"T\u00f8nnesen","year":"2023","journal-title":"Europace"},{"key":"2025021117521154700_euae203-B18"},{"key":"2025021117521154700_euae203-B19","doi-asserted-by":"crossref","first-page":"163","DOI":"10.36290\/vnl.2017.035","article-title":"Radiofrequency catheter ablation of atrial fibrillation performed under general anesthesia: results of a unicentric randomized trial","volume":"63","author":"Sta\u0161kov\u00e1","year":"2017","journal-title":"Vnitr Lek"},{"key":"2025021117521154700_euae203-B20","doi-asserted-by":"crossref","first-page":"162","DOI":"10.5507\/bp.2020.012","article-title":"General anesthesia or conscious sedation in paroxysmal atrial fibrillation catheter ablation","volume":"165","author":"Moravec","year":"2021","journal-title":"Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub"},{"key":"2025021117521154700_euae203-B21","doi-asserted-by":"crossref","first-page":"576","DOI":"10.3390\/jcm13020576","article-title":"Focal pulsed field ablation for atrial arrhythmias: efficacy and safety under deep sedation","volume":"13","author":"Weyand","year":"2024","journal-title":"J Clin Med"},{"key":"2025021117521154700_euae203-B22","doi-asserted-by":"crossref","first-page":"euae043","DOI":"10.1093\/europace\/euae043","article-title":"2024 European Heart Rhythm Association\/Heart Rhythm Society\/Asia Pacific Heart Rhythm Society\/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation","volume":"26","author":"Tzeis","year":"2024","journal-title":"Europace"},{"key":"2025021117521154700_euae203-B23","doi-asserted-by":"crossref","first-page":"2616","DOI":"10.12659\/MSM.896675","article-title":"Novel P wave indices to predict atrial fibrillation recurrence after radiofrequency ablation for paroxysmal atrial fibrillation","volume":"22","author":"Hu","year":"2016","journal-title":"Med Sci Monit"},{"key":"2025021117521154700_euae203-B24","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.smrv.2017.08.005","article-title":"Sleep, sleep apnea and atrial fibrillation: questions and answers","volume":"39","author":"Kwon","year":"2018","journal-title":"Sleep Med Rev"},{"key":"2025021117521154700_euae203-B25","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.jelectrocard.2019.01.089","article-title":"Coefficient of variation of P-wave duration measured using an automated measurement system predicts recurrence of atrial fibrillation","volume":"53","author":"Nakatani","year":"2019","journal-title":"J Electrocardiol"},{"key":"2025021117521154700_euae203-B26","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1093\/europace\/euaa132","article-title":"Predictors of recurrence of atrial fibrillation within the first 3 months after ablation","volume":"22","author":"Zink","year":"2020","journal-title":"Europace"},{"key":"2025021117521154700_euae203-B27","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1007\/s10840-021-01049-0","article-title":"Post-ablation P wave characteristics correlate with recurrent atrial fibrillation in the ABCD-AF cohort","volume":"64","author":"Supanekar","year":"2022","journal-title":"J Interv Card Electrophysiol"},{"key":"2025021117521154700_euae203-B28","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.hroo.2022.02.011","article-title":"Deep sedation with propofol in patients undergoing left atrial ablation procedures-is it safe?","volume":"3","author":"Foerschner","year":"2022","journal-title":"Heart Rhythm O2"},{"key":"2025021117521154700_euae203-B29","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"}],"container-title":["Europace"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/europace\/advance-article-pdf\/doi\/10.1093\/europace\/euae203\/58744651\/euae203.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/26\/8\/euae203\/60495400\/euae203.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/26\/8\/euae203\/60495400\/euae203.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T17:52:35Z","timestamp":1739296355000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/doi\/10.1093\/europace\/euae203\/7728002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":29,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8,3]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euae203","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,8]]},"published":{"date-parts":[[2024,8]]},"article-number":"euae203"}}