Moderate sedation in cardiac electrophysiology laboratory: a retrospective safety analysis

Sawhney et al reported that nurse-led, physician-directed moderate sedation during cardiac electrophysiology procedures is safe.1 All of the patients undergoing cardiac electrophysiological (EP) procedures and cardiac implantable electronic device (CIED) implantation during the last 12 years were moderately sedated. Since this study is a retrospective study, we could not comprehend why all patients were sedated despite the fact that routine sedation during all cardiac EP procedures and all CIED implantation is not recommended.

Moreover, as mentioned in the article, sedation is a continuum and it is not always possible to predict how individual patients will respond. Therefore, a gradual increase of doses of the sedatives during sedation may be needed, which may possibly increase the procedure duration. Did authors ascertain any prolongation of the procedures due to sedative administration?

Furthermore, sedation may diminish arrhythmia induction during EP procedures, particularly in patients with catecholamine-sensitive ventricular tachycardias.2...