IMPROVING ANESTHESIOLOGICAL SUPPORT IN PLANNED RADIOFREQUENCY ABLATIONS

Abstract. This article is dedicated to the issues of optimizing anesthesiological support during radiofrequency catheter ablation (RFCA) in the condition of atrial fibrillation (AF) – a chronic cardiac rhythm disorder characterized by the emergence of irregular electrical impulses in the atria. AF is electrocardiographically manifested by the absence of P waves, fibrillatory waves, and irregularly irregular R–R intervals, leading to reduced cardiac output and hemodynamic disturbances. The article analyzes the role of sedation depth in improving RFCA outcomes, as sedation controls patient movement, respiratory rhythm, and autonomic responses, thereby determining the quality of the ablation technique. The authors consider sedation not only as a means of patient comfort but as an integrated element of treatment efficacy and safety. The article provides a detailed analysis of the impact of sedation depth on catheter stability, accuracy of electroanatomical mapping, and continuity of lesion formation. In moderate sedation, patient movement and irregular breathing can lead to catheter displacement, which increases the inefficiency of pulmonary vein isolation. Deep sedation or general anesthesia ensures patient immobility but amplifies respiratory (hypoventilation, apnea, hypoxemia) and hemodynamic (vasodilation, bradycardia, hypotension) risks, particularly in patients with obesity, obstructive sleep apnea, or heart failure. The authors emphasize the necessity of individually selecting sedation depth based on the patient's risk profile (e.g., pulmonary reserve, procedure complexity).

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