关键词: 心房颤动, 射频消融术, 电复律, 清醒状态, 镇静状态

Abstract: Objective To compare the safety and efficacy of awake state and sedation state in patients with atrial fibrillation（AF）who did not recover sinus rhythm and needed electrical cardioversion during operation. Methods A total of 100 patients with persistent atrial fibrillation who underwent synchronous direct current cardioversion during radiofrequency ablation from January 2022 to December 2023 were selected and divided into the observation group（awake state）and the control group（sedation state）according to the random number table method,with 50 cases in each group．The success rate of electrical cardioversion,recurrence rate and incidence of adverse events（respiratory depression,hypotension,delirium,pulmonary edema,arrhythmia）were observed. Results The first electrical cardioversion was successful in 48 and 49 patients in the observation group and the control group,and the success rates were 96% and 98%,respectively．There was no significant difference between the two groups（P=0.558）．There were 2 cases of recurrence in the observation group and no recurrence in the control group within 30 minutes after operation,and there was no significant difference between the two groups（P=0.153）．In terms of adverse reactions,there were 1 case of arrhythmia event and 1 case of hypotension event in the observation group,and the total incidence of adverse reactions was 4%．There were 3 cases of respiratory depression events,2 cases of delirium events,1 case of arrhythmia events,and 2 cases of hypotension events in the control group．The total incidence of adverse reactions was 16%,and the difference between the two groups was statistically significant（P=0.046）. Conclusions Electrical cardioversion in awake state during radiofrequency ablation of persistent atrial fibrillation has a good clinical efficacy and safety,which can reduce the occurrence of adverse events．

Key words: atrial fibrillation, radio frequency ablation, electric cardioversion, state of wakefulness, sedation