Asmeton minimizes dry cough and diaphragmatic contraction during pulsed-field ablation of atrial fibrillation: a clinical prospective randomized study.

PURPOSE: Pulsed-field ablation (PFA) is a novel ablation modality with promising outcomes for atrial fibrillation therapy. However, PFA might lead to dry cough and diaphragmatic contraction, especially under conscious sedation. We aim to explore a novel approach to reduce dry cough and diaphragmatic contraction during PFA procedures performed under conscious sedation.

METHODS

A total of 16 patients who underwent PFA pulmonary vein isolation under conscious sedation were divided into the asmeton (with preprocedure asmeton) and control groups. A scoring system was developed to assess dry cough and diaphragmatic contraction.

RESULTS

A total of 608 ablations and 893 ablations were performed in the control and asmeton groups, respectively. The dry cough score (P = 0.045) in all pulmonary veins was significantly reduced by 73.1% in the asmeton group in comparison with the control group. The proportion of medium-to-high dry cough incidences decreased from 12.2 ± 10.4% in the control group to 1.8 ± 3.7% in the asmeton group (P = 0.027). The diaphragmatic contraction score in the asmeton group was 37.5% lower than that in the control group, and the proportion of severe diaphragmatic contraction incidences was significantly reduced from 2.8 ± 8.4% in the control group to 0.0 ± 0.0% in the asmeton group (P = 0.006).

CONCLUSION

Asmeton might eliminate moderate-to-severe dry cough and reduce the severity of diaphragmatic contraction during pulmonary vein isolation under conscious sedation ablation.