Obstructive respiratory events during procedural sedation and analgesia: Another WHY to routinely screen for sleep apnea before catheter ablation of atrial fibrillation

Recent highlights on the prevalence and role of sleep disordered breathing in cardiovascular diseases from the International Journal of Cardiology Heart & Vasculature

“…Therefore, undiagnosed SDB in patients with AF is an underutilized opportunity for arrhythmia treatment, although SDB management in patients with AF requires a multidisciplinary and personalized management approach [29] , [30] . Besides this, SDB, together with concomitant obesity and chronic obstructive pulmonary disease [31] , increases the risk of periprocedural hypoxia and carbon dioxide accumulation in AF patients undergoing AF ablation with deep conscious sedation [32] , [33] . In this setting, hypnotic communication for periprocedural analgesia instead of pharmacological sedation may decrease the risk of respiratory insufficiency in these patients [34] , [35] , [36] .…”

Does weight matter in cryoballoon ablation?

“…Obese patients tend to have thicker chest walls and increased amounts of fat tissue, which may make catheter movements and adequate visualization of the pulmonary vein occlusion challenging despite increased radiation exposure for the patient and the operator during the CBA procedure. Besides this, obese patients may have a higher risk of anesthesia-related complications due to comorbidities such as obstructive sleep apnea and respiratory issues [13] , [14] , [15] . It is generally accepted that CBA procedures may take longer in obese patients compared to non-obese patients, although efficacy and safety of CBA in obese patients appear to be comparable to non-obese patients [16] , [17] .…”