Comparison of Propofol and Ketamine for Sedation in Patients Undergoing Radiofrequency Ablation for Atrial Fibrillation

OBJECTIVE
Catheter-based ablation is now widely recognized as a beneficial therapeutic option for managing atrial fibrillation (AF). However, the extended duration and pain associated with the procedure may cause patient movements, potentially leading to disruptions in the electro-anatomical mapping systems. Sedative and analgesic agents are used to prevent body movements and manage pain. This study aimed to conduct a comparison between the safety and effects of ketamine and propofol for deep sedation on outcomes in AF patients undergoing radiofrequency ablation.

METHODS
This retrospective and single-center study included 108 patients who underwent radiofrequency AF ablation under deep sedation (without intubation) in our hospital. The patients were categorized into two groups based on the anesthetic agent administered for deep sedation: the propofol group and the ketamine group. Procedure duration, success rates, and recovery times were compared.

RESULTS
Of the 108 patients, 54 were in the propofol group and 54 were in the ketamine group. The procedure durations were similar in both groups (propofol group: 135 min (120 – 145) vs. ketamine group: 140 min (120 – 155), p=0.803). The eye-opening time after the procedure was 275 seconds in the propofol group and 266 seconds in the ketamine group (p=0.530). Additionally, no significant variation was detected in the initial measurements of systolic and diastolic blood pressure or heart rate.

CONCLUSION
In conclusion, there was no significant difference between the propofol group and the ketamine group in terms of outcomes. To the best of our knowledge, this is the first study to assess the efficacy of ketamine and propofol in the radiofrequency AF ablation patient group.