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Arrhythmias and sudden death
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Moderate sedation in cardiac electrophysiology laboratory: a retrospective safety analysis
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  • Published on: 14 July 2017
    Moderate Sedation in Cardiac Electrophysiology Laboratory: a retrospective safety analysis
    • Çağın Mustafa ÜREYEN, Cardiology Specialist, MD Sakarya University, Education and Research Hospital, Department of Cardiology
    • Other Contributors:
      • Murat AKSOY, Cardiology Specialist, MD
      • Ersan TATLI, Cardiology Specialist, MD

    Sawhney et al. reported that nurse-led, physician-directed moderate sedation during cardiac electrophysiology procedures is safe (1). All of the patients undergoing cardiac electrophysiological (EP) procedures and cardiac implantable electronic device (CIED) implantation during the last 12 years were moderately sedated. Since this study is a retrospective study, we could not comprehend why all patients were sedated despite the fact that routine sedation during all cardiac EP procedures and all CIED implantation is not recommended.
    Moreover, as mentioned in the article, sedation is a continuum and it is not always possible to predict how individual patients will respond. Therefore, a gradual increase of doses of the sedatives during sedation may be needed which may possibly increase the procedure duration. Did authors ascertain any prolongation of the procedures due to sedative administration?
    Furthermore, sedation may diminish arrythmia induction during EP procedures, particularly in patients with catecholamine-sensitive ventricular tachycardias (2). Did authors have any data questioning this issue?
    As a conclusion, the aim of sedation is to diminish the anxiety and to relieve the pain during the procedure. Therefore, using moderate sedation selectively in patients with anxiety or hyperalgesia may be more practical and rational rather than its routine use due to the fact that as mentioned in the article, researches and audit demonstrate continued avoidabl...

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    Conflict of Interest:
    None declared.