ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2023
Respiratory control minimizes diaphragmatic contraction and dry cough during pulsed-field ablation of atrial fibrillation.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 13 citations in OpenAlex.
- A Simple Manual Maneuver for Suspected Back-Patch-Related Positional Alerts During Pulsed Field Ablation.Journal of arrhythmia · 2026Article
- Comparison of HEMOlysis Markers Among Three Pulsed Field Ablation Systems: HEMO-PFA Study.Journal of cardiovascular electrophysiology · 2026Article
- Impact of Curarization on Pentaspline Catheter Stability During Pulsed-Field Pulmonary Vein Ablation.Journal of cardiovascular electrophysiology · 2026Article
- Sedation Strategies, Drugs, and Protocols Used in Catheter Ablation of Atrial Fibrillation: A Focused Review.Reviews in cardiovascular medicine · 2026Review
- Relationship between coughing and bispectral index-guided sedation during pulsed field ablation for atrial fibrillation and its impact on mid-term outcomes.Heart rhythm O2 · 2026Article
- Circular over-the-wire pulsed field ablation for atrial fibrillation: differences in outcomes between conscious sedation or general anesthesia.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Difficult ventilation with suspected laryngospasm in patients undergoing pulsed field ablation for atrial fibrillation under general anesthesia using laryngeal mask airway: A case series.HeartRhythm case reports · 2025Article
- Laryngospasm during pulsed field ablation: A sign of warning for a device-specific complication?HeartRhythm case reports · 2025Article
- Incidence of cough reflex and vagal response among various pulsed field ablation systems: a multicenter registry study.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Article
- Takotsubo Syndrome Following Pulmonary Vein Isolation With Pulse Field Ablation.JACC. Case reports · 2025Article
- Asmeton minimizes dry cough and diaphragmatic contraction during pulsed-field ablation of atrial fibrillation: a clinical prospective randomized study.Frontiers in physiology · 2025Article
- State-of-the-art pulsed field ablation for cardiac arrhythmias: ongoing evolution and future perspective.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Review
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Authors and funding
16 authors at 2 institutions in 3 countries.
Funding
Abstract
aimsPulsed-field ablation (PFA) is a promising new ablation modality to treat atrial fibrillation. However, PFA can cause varying degrees of diaphragmatic contraction and dry cough, especially under conscious sedation. This prospective study presents a method to minimize the impact of PFA on diaphragmatic contraction and dry cough during the procedure. METHODS AND
resultsTwenty-eight patients underwent PFA for pulmonary vein (PV) and superior vena cava isolation under conscious sedation. Each patient received two groups of ablations in each vein: the control group allowed PFA application during any phase of respiratory cycle, while the test group used respiratory control, delivering PFA energy only at the end of expiration. A rating score system was developed to assess diaphragmatic contraction and dry cough. A total of 1401 control ablations and 4317 test ablations were performed. The test group had significantly lower scores for diaphragmatic contraction (P < 0.01) and dry cough (P < 0.001) in all PVs compared to the control group. The average relative reductions in scores for all PVs were 33-47% for diaphragmatic contraction and 67-83% for dry cough. The percentage of ablations with scores ≧2 for diaphragmatic contraction decreased significantly from 18.5-28.0% in the control group to 0.4-2.6% in the test group (P < 0.001). For dry cough, the percentage decreased from 11.9-43.7% in the control group to 0.7-2.1% in the test group.
conclusionPulsed-field ablation application at the end of expiration can reduce the severity of diaphragmatic contraction and eliminate moderate and severe dry cough during PV isolation performed under conscious sedation.
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