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Procedural Sedation for Atrial Fibrillation Patients

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Short Stay Management of Atrial Fibrillation

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Procedural sedation and analgesia, formerly conscious sedation, is the process of administering sedatives or dissociative agents concurrently with analgesics as indicated, in order to create an altered state of consciousness allowing the patient to undergo unpleasant and/or painful procedures while preserving cardiovascular function. Analgesia is pain relief without the intentional alteration of mental status. In addition to the many procedures that any individual may undergo that may require procedural sedation and analgesia, from fracture reduction to the insertion of tubes to wound care, patients with atrial fibrillation may also need to undergo cardioversion. Patients with atrial fibrillation range from the newborn with congenital heart disease to the essentially healthy individual with a structurally normal heart to the hemodynamically unstable geriatric patient with multiple comorbidities and end-stage heart failure. Providing procedural sedation and analgesia to patients with atrial fibrillation presents additional problems and adds another layer of complexity to the sedation. Patients with atrial fibrillation often have higher American Society of Anesthesia (ASA) physical status classification which puts them at much greater risk for complications during sedation. The cardiovascular effects of the various medications used during procedural sedation and analgesia need to be kept in mind when sedating patients with atrial fibrillation. This may limit the choices of medications used for the procedural sedation and analgesia.

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Professor of Medicine Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA

    Sharon E. Mace MD, FACEP, FAAP

  2. Research and Observation Unit, Emergency Services Institute, Cleveland Clinic, 9500 Euclid Ave, E- 19, Cleveland, OH, USA

    Sharon E. Mace MD, FACEP, FAAP

Authors
  1. Sharon E. Mace MD, FACEP, FAAP
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Correspondence to Sharon E. Mace MD, FACEP, FAAP .

Editor information

Editors and Affiliations

  1. Baylor College of Medicine, Department of Emergency Medicine Baylor College of Medicine, HOUSTON, Texas, USA

    W. Frank Peacock

  2. Department of Emergency Medicine, Beaumont Health System, William Beaumont Hospital, William Beaumont School of Medicine, Oakland University, Royal Oak, Michigan, USA

    Carol L. Clark

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Mace, S.E. (2016). Procedural Sedation for Atrial Fibrillation Patients. In: Peacock, W., Clark, C. (eds) Short Stay Management of Atrial Fibrillation. Contemporary Cardiology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-31386-3_11

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  • DOI: https://doi.org/10.1007/978-3-319-31386-3_11

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-31384-9

  • Online ISBN: 978-3-319-31386-3

  • eBook Packages: MedicineMedicine (R0)

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