A small ablation series reported successful conscious sedation and high satisfaction, but the pain scores prevent calling the procedure painless.
What the 14-patient series reported
Consecutive patients undergoing a first pulmonary vein isolation with a balloon-in-basket pulsed field ablation system received conscious sedation using midazolam, fentanyl, metamizole, and lidocaine. Propofol was reserved for electrical cardioversion rather than routine ablation sedation.
None required escalation to deep sedation. Median pain during the procedure was 6.5 on a ten-point scale, falling to two afterward and on the next day. Satisfaction and willingness to recommend the approach were high.
Feasible does not mean superior
This single-center observational series had no randomized deep-sedation comparison and was too small to assess rare complications. High satisfaction can coexist with considerable pain; it should not be substituted for the pain outcome. The combination regimen also prevents attributing procedural tolerance to midazolam alone.
For a procedural review, separate patient alertness, pain, ventilation, escalation, and later satisfaction. These endpoints describe different aspects of care. The report supports feasibility in a selected small group, while leaving unresolved comparative safety, the best sedation approach, and applicability to different patients or ablation systems.
Source paper
Original analysis of the supplied journal article, identified as PMC12925817.
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