{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:36:59Z","timestamp":1786739819513,"version":"build-2736575974"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Ventricular arrhythmias (VA), including ventricular tachycardia and fibrillation, are critical cardiac conditions that are often managed by catheter ablation among those unresponsive to pharmacologic therapy. The choice of anesthesia and sedation regimens for VA ablations may impact arrhythmia inducibility and hemodynamic stability, which can affect procedural success and complication rates. This systematic review and meta-analysis aimed to compare the efficacy and safety of sedation versus general anesthesia (GA) among patients undergoing VA ablation. The review was prospectively registered on PROSPERO (CRD42023441553). Database searches were conducted across five major databases from inception to March 9, 2024 to identify randomized trials or observational studies including adult patients undergoing ablations for VA. Screening and data extraction were completed in duplicate. Risk-of-bias assessments were conducted using ROBINS-I as all included studies were observational, and the quality of evidence was evaluated using the GRADE framework. Six observational studies (N = 16,435) were included. No significant differences were found between sedation and GA for total procedure time (MD: \u221214.16 minutes; 95%CI: \u221238.61 to 10.29 minutes), arrhythmia non-inducibility (RR: 0.73; 95% CI: 0.33\u20131.58), acute ablation success (RR: 1.06; 95% CI: 0.65\u20131.71), or procedural complications (RR: 0.72; 95% CI: 0.28\u20131.85). However, sedation was associated with significantly lower intraprocedural hemodynamic instability (RR: 0.28; 95% CI: 0.12\u20130.70). These findings indicate that while sedation and GA have comparable outcomes, sedation may be associated with less hemodynamic instability during VA ablation. However, more high-quality studies are needed to confirm these results.<\/jats:p>","DOI":"10.4103\/aca.aca_229_24","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T11:00:12Z","timestamp":1744801212000},"page":"119-127","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Sedation Versus General Anesthesia for Ablation of Ventricular Arrhythmias: A Systematic Review and Meta-Analysis"],"prefix":"10.4103","volume":"28","author":[{"given":"Shubh","family":"Patel","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawen","family":"Deng","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areeba","family":"Zubair","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyan","family":"Heybati","sequence":"additional","affiliation":[{"name":"Alix School of Medicine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayan","family":"Heybati","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Queen\u2019s University, Kingston, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oswin","family":"Chang","sequence":"additional","affiliation":[{"name":"UBC Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umaima","family":"Abbas","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine and Dentistry (Windsor), Western University, Windsor, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umair","family":"Tahir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harikrishnaa B.","family":"Ramaraju","sequence":"additional","affiliation":[{"name":"VCU School of Medicine, Virginia Commonwealth University, Richmond, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Y.","family":"Wong","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote School of Medicine (Waterloo Regional Campus), McMaster University, Kitchener, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanansayan","family":"Dhivagaran","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine and Dentistry (Windsor), Western University, Windsor, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Rayner","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Krever","sequence":"additional","affiliation":[{"name":"Clinical Research, Sinai Health System, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Woelber","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurukripa N.","family":"Kowlgi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harish","family":"Ramakrishna","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"key":"R1-20250416","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1093\/europace\/euz132","article-title":"2019 HRS\/EHRA\/APHRS\/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias","volume":"21","author":"Cronin","year":"2019","journal-title":"Europace"},{"key":"R2-20250416","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1016\/j.jacc.2011.06.022","article-title":"Activation and entrainment mapping of hemodynamically unstable ventricular tachycardia using a percutaneous left ventricular assist device","volume":"58","author":"Miller","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"R3-20250416","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1111\/j.1540-8167.2010.01889.x","article-title":"Remifentanil-midazolam sedation provides hemodynamic stability and comfort during epicardial ablation of ventricular tachycardia","volume":"22","author":"Mandel","year":"2011","journal-title":"J Cardiovasc Electrophysiol"},{"key":"R4-20250416","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s10840-022-01350-6","article-title":"Dexmedetomidine for sedation during epicardial ablation for ventricular tachycardia:A single-center experience","volume":"66","author":"Conti","year":"2023","journal-title":"J Interv Card Electrophysiol"},{"key":"R5-20250416","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1111\/j.1540-8159.2011.03260.x","article-title":"Safety aspects of deep sedation during catheter ablation of atrial fibrillation","volume":"35","author":"Wutzler","year":"2012","journal-title":"Pacing Clin Electrophysiol"},{"key":"R6-20250416","doi-asserted-by":"crossref","first-page":"2135","DOI":"10.1007\/s10840-023-01557-1","article-title":"Impact of anesthetic management on catheter ablation for premature ventricular complexes:Insights during the COVID-19 outbreak","volume":"66","author":"Kazawa","year":"2023","journal-title":"J Interv Card Electrophysiol"},{"key":"R7-20250416","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1093\/bja\/aet168","article-title":"Propofol for adult procedural sedation in a UK emergency department:Safety profile in 1008 cases","volume":"111","author":"Newstead","year":"2013","journal-title":"Br J Anaesth"},{"issue":"15","key":"R8-20250416","first-page":"ii189","article-title":"Propofol sedation administered by cardiologists without assisted ventilation is safe for patients undergoing catheter ablation for ventricular tachycardia","volume":"6","author":"Servatius","year":"2013","journal-title":"Europace"},{"key":"R9-20250416","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1111\/jce.12001","article-title":"Conscious sedation and anesthesia in the cardiac electrophysiology laboratory","volume":"24","author":"L\u00fc","year":"2013","journal-title":"J Cardiovasc Electrophysiol"},{"key":"R10-20250416","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.ijcard.2013.12.175","article-title":"Minimal and deep sedation during ablation of ventricular tachycardia","volume":"172","author":"Wutzler","year":"2014","journal-title":"Int J Cardiol"},{"key":"R11-20250416","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.1016\/j.hrthm.2015.06.018","article-title":"Impact of general anesthesia on initiation and stability of VT during catheter ablation","volume":"12","author":"Nof","year":"2015","journal-title":"Heart Rhythm"},{"key":"R12-20250416","doi-asserted-by":"crossref","first-page":"e1003583","DOI":"10.1371\/journal.pmed.1003583","article-title":"The PRISMA 2020 statement:An updated guideline for reporting systematic reviews","volume":"18","author":"Page","year":"2021","journal-title":"PLoS Med"},{"key":"R14-20250416","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/02763869.2019.1588072","article-title":"PROSPERO:An International Register of Systematic Review Protocols","volume":"38","author":"Schiavo","year":"2019","journal-title":"Med Ref Serv Q"},{"key":"R16-20250416","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1177\/09622802231172043","article-title":"Detecting the skewness of data from the five-number summary and its application in meta-analysis","volume":"32","author":"Shi","year":"2023","journal-title":"Stat Methods Med Res"},{"key":"R17-20250416","doi-asserted-by":"crossref","first-page":"2701","DOI":"10.1177\/09622802211047348","article-title":"Estimating the sample mean and standard deviation from order statistics and sample size in meta-analysis","volume":"30","author":"Cai","year":"2021","journal-title":"Stat Methods Med Res"},{"key":"R18-20250416","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1177\/09622802221139233","article-title":"Standard error estimation in meta-analysis of studies reporting medians","volume":"32","author":"McGrath","year":"2023","journal-title":"Stat Methods Med Res"},{"key":"R19-20250416","doi-asserted-by":"crossref","first-page":"2520","DOI":"10.1177\/0962280219889080","article-title":"Estimating the sample mean and standard deviation from commonly reported quantiles in meta-analysis","volume":"29","author":"McGrath","year":"2020","journal-title":"Stat Methods Med Res"},{"key":"R20-20250416","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I:A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"R21-20250416","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1136\/ebmental-2019-300117","article-title":"How to perform a meta-analysis with R:A practical tutorial","volume":"22","author":"Balduzzi","year":"2019","journal-title":"Evid Based Ment Health"},{"key":"R22-20250416","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1002\/sim.1761","article-title":"What to add to nothing?Use and avoidance of continuity corrections in meta-analysis of sparse data","volume":"23","author":"Sweeting","year":"2004","journal-title":"Stat Med"},{"key":"R23-20250416","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1016\/S0895-4356(00)00242-0","article-title":"Publication and related bias in meta-analysis:Power of statistical tests and prevalence in the literature","volume":"53","author":"Sterne","year":"2000","journal-title":"J Clin Epidemiol"},{"key":"R24-20250416","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1002\/sim.1461","article-title":"Adjusting for publication bias in the presence of heterogeneity","volume":"22","author":"Terrin","year":"2003","journal-title":"Stat Med"},{"key":"R25-20250416","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE:An emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"R26-20250416","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.jclinepi.2022.07.014","article-title":"GRADE Guidance 34:Update on rating imprecision using a minimally contextualized approach","volume":"150","author":"Zeng","year":"2022","journal-title":"J Clin Epidemiol"},{"key":"R27-20250416","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1016\/j.jclinepi.2011.01.012","article-title":"GRADE guidelines 6. Rating the quality of evidence--imprecision","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"R28-20250416","first-page":"51","article-title":"How to calculate sample size in randomized controlled trial?","volume":"1","author":"Zhong","year":"2009","journal-title":"J Thorac Dis"},{"key":"R29-20250416","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE guidelines:1. Introduction-GRADE evidence profiles and summary of findings tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"R30-20250416","first-page":"137","article-title":"Anesthetic management for ventricular tachycardia ablation:A national anesthesia clinical outcomes registry analysis","volume":"134","author":"Dada","year":"2022","journal-title":"Anesth Analg"},{"key":"R31-20250416","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1053\/j.jvca.2023.12.021","article-title":"Anesthetic management for ventricular tachycardia ablation:A national anesthesia clinical outcomes registry analysis","volume":"38","author":"Dada","year":"2024","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"Suppl_2","key":"R32-20250416","first-page":"ehad655","article-title":"A comparison of general anesthesia versus monitored anesthesia care during catheter ablation for ventricular tachycardia","volume":"44","author":"Woelber","year":"2023","journal-title":"Eur Heart J"},{"key":"R33-20250416","doi-asserted-by":"crossref","first-page":"e007669","DOI":"10.1161\/CIRCEP.119.007669","article-title":"Catheter ablation in patients with cardiogenic shock and refractory ventricular tachycardia","volume":"13","author":"Ballout","year":"2020","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"R34-20250416","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1093\/europace\/euaa371","article-title":"Mechanical circulatory support in the management of life-threatening arrhythmia","volume":"23","author":"Della","year":"2021","journal-title":"Europace"},{"key":"R35-20250416","doi-asserted-by":"crossref","first-page":"e004492","DOI":"10.1161\/CIRCEP.116.004492","article-title":"Extracorporeal membrane oxygenation for hemodynamic support of ventricular tachycardia ablation","volume":"9","author":"Baratto","year":"2016","journal-title":"Circ Arrhythm Electrophysiol"}],"container-title":["Annals of Cardiac Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_229_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:34:01Z","timestamp":1786736041000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_229_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":33,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/aca.aca_229_24","relation":{},"ISSN":["0971-9784","0974-5181"],"issn-type":[{"value":"0971-9784","type":"print"},{"value":"0974-5181","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-11-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}