Design of a quantitative approach for sedation protocol assessment in pulsed field ablation

During the past three decades, catheter and surgical ablation of atrial fibrillation (AF) have evolved from investigational procedures to their current role as effective treatment options for patients with AF. Surgical ablation of AF, using either standard, minimally invasive, or hybrid techniques, is available in most major hospitals throughout the world. Catheter ablation of AF is even more widely available and is now the most commonly performed catheter ablation procedure. [1] Today there are many types of catheter ablation, such as the Radio Frequency ablation and the Cryo-Energy ablation. However Thermal-based ablation for the treatment of arrhythmias is known to cause issues that hamper the success of the treatment. A novel technique has been introduced, termed “electroporation” (PFA) is a process that leads to pore formation in cell membranes. These pores may cause cellular death without inducing negative thermal effects.[2] Among cell types, cardiomyocytes have among the lowest thresholds to these fields, potentially permitting preferential myocardial ablation.[3] Unfortunately, differently from the thermal-based ablation, PFA required the patient to be sedated during ablation procedure. The purpose of this thesis is to study the respiratory rate of a patient population that undergo to PFA under a new sedation protocol aim at allowing the patient breathing on his own and at reducing pain, caused by high energy delivered during PFA.