Abstract：
The authors evaluated the type of anesthesia administered in atrial fibrillation ablation, hypothesizing that monitored anesthesia care is used less frequently than general anesthesia.
A retrospective study.
National Anesthesia Clinical Outcomes Registry data, which are multi-institutional from across the United States.
Adult patients who underwent elective atrial fibrillation ablation between 2013 and 2018.
None.
National Anesthesia Clinical Outcomes Registry data were evaluated, and covariates were selected a priori within multivariate models to assess for predictors of anesthetic type. A total of 54,321 patients underwent atrial fibrillation ablation; 3,251 (6.0%) received monitored anesthesia care. Patients who received monitored anesthesia care were more likely to be >80 years old (12.4% v 4.9%; p < 0.0001), female (36.1% v 34.3%; p < 0.0001), have American Society of Anesthesiologists physical status >III (17.28% v 10.48%; p < 0.0001), and reside in urban areas (62.23% v 53.37%; p < 0.0001). They received care in the Northeast (17.6% v 10.1%; p < 0.0001) at low-volume centers (median 224 v 284 procedures; p < 0.0001). Multivariate analysis revealed that each five-year increase in age, being female, and having an American Society of Anesthesiologists physical status >III resulted in a 7% (p < 0.0001), 9% (p = 0.032), and 200% (p < 0.0001) increased odds of receiving monitored anesthesia care, respectively. Requiring additional ablation of atria or of a second arrhythmia and residing outside the Northeast resulted in a decreased odds of monitored anesthesia care (adjusted odds ratio 0.24 [p=0.002] and < 0.5 [p < 0.03], respectively). For each 50 cases performed annually at a center, the odds decreased by 5% (p = 0.005).
General anesthesia is the most common type of anesthesia administered for atrial fibrillation ablation. The type of anesthesia administered, however, varies with patient, procedural, and hospital characteristics.
A retrospective study.
National Anesthesia Clinical Outcomes Registry data, which are multi-institutional from across the United States.
Adult patients who underwent elective atrial fibrillation ablation between 2013 and 2018.
None.
National Anesthesia Clinical Outcomes Registry data were evaluated, and covariates were selected a priori within multivariate models to assess for predictors of anesthetic type. A total of 54,321 patients underwent atrial fibrillation ablation; 3,251 (6.0%) received monitored anesthesia care. Patients who received monitored anesthesia care were more likely to be >80 years old (12.4% v 4.9%; p < 0.0001), female (36.1% v 34.3%; p < 0.0001), have American Society of Anesthesiologists physical status >III (17.28% v 10.48%; p < 0.0001), and reside in urban areas (62.23% v 53.37%; p < 0.0001). They received care in the Northeast (17.6% v 10.1%; p < 0.0001) at low-volume centers (median 224 v 284 procedures; p < 0.0001). Multivariate analysis revealed that each five-year increase in age, being female, and having an American Society of Anesthesiologists physical status >III resulted in a 7% (p < 0.0001), 9% (p = 0.032), and 200% (p < 0.0001) increased odds of receiving monitored anesthesia care, respectively. Requiring additional ablation of atria or of a second arrhythmia and residing outside the Northeast resulted in a decreased odds of monitored anesthesia care (adjusted odds ratio 0.24 [p=0.002] and < 0.5 [p < 0.03], respectively). For each 50 cases performed annually at a center, the odds decreased by 5% (p = 0.005).
General anesthesia is the most common type of anesthesia administered for atrial fibrillation ablation. The type of anesthesia administered, however, varies with patient, procedural, and hospital characteristics.
摘要：
作者评估了房颤消融的麻醉类型，假设监测麻醉护理的使用频率低于全身麻醉。
一项回顾性研究。
全国麻醉临床结果登记数据，来自美国各地的多机构。
2013年至2018年间接受选择性心房颤动消融的成年患者。
无。
评估了全国麻醉临床结果注册数据，和协变量在多变量模型中进行先验选择,以评估麻醉类型的预测因子.共有54,321例患者接受了心房颤动消融术;3,251例(6.0%)接受了监测麻醉护理。接受监测麻醉护理的患者更可能>80岁(12.4%v4.9%;p<0.0001)，女性（36.1%对34.3%；p<0.0001），美国麻醉医师协会的身体状况>III（17.28%对10.48%；p<0.0001），居住在城市地区（62.23%对53.37%；p<0.0001）。他们在东北部接受了低容量中心的护理（17.6％v10.1％；p<0.0001）（中位数224v284程序；p<0.0001）。多变量分析显示，年龄每增加五年，作为女性，美国麻醉医师协会的身体状况>III导致7%(p<0.0001)，9%(p=0.032)，接受监测麻醉护理的几率增加了200%(p<0.0001)，分别。需要额外消融心房或二次心律失常并居住在东北以外导致监测麻醉护理的几率降低(调整后的比值比0.24[p=0.002]和<0.5[p<0.03],分别)。对于每年在一个中心进行的每50个案例，几率下降了5%(p=0.005)。
全身麻醉是用于心房颤动消融的最常见的麻醉类型。麻醉的类型，然而,因患者而异，程序,医院特色。
一项回顾性研究。
全国麻醉临床结果登记数据，来自美国各地的多机构。
2013年至2018年间接受选择性心房颤动消融的成年患者。
无。
评估了全国麻醉临床结果注册数据，和协变量在多变量模型中进行先验选择,以评估麻醉类型的预测因子.共有54,321例患者接受了心房颤动消融术;3,251例(6.0%)接受了监测麻醉护理。接受监测麻醉护理的患者更可能>80岁(12.4%v4.9%;p<0.0001)，女性（36.1%对34.3%；p<0.0001），美国麻醉医师协会的身体状况>III（17.28%对10.48%；p<0.0001），居住在城市地区（62.23%对53.37%；p<0.0001）。他们在东北部接受了低容量中心的护理（17.6％v10.1％；p<0.0001）（中位数224v284程序；p<0.0001）。多变量分析显示，年龄每增加五年，作为女性，美国麻醉医师协会的身体状况>III导致7%(p<0.0001)，9%(p=0.032)，接受监测麻醉护理的几率增加了200%(p<0.0001)，分别。需要额外消融心房或二次心律失常并居住在东北以外导致监测麻醉护理的几率降低(调整后的比值比0.24[p=0.002]和<0.5[p<0.03],分别)。对于每年在一个中心进行的每50个案例，几率下降了5%(p=0.005)。
全身麻醉是用于心房颤动消融的最常见的麻醉类型。麻醉的类型，然而,因患者而异，程序,医院特色。
