Kahraman Coşansu

Use of neutrophil-lymphocyte ratio for risk stratification and relationship with time in therapeutic range in patients with nonvalvular atrial fibrillation: A pilot study

Atrial fibrillation is one of the most common abnormal heart rhythms. Neutrophil‐lymphocyte ratio (NLR) has emerged as a potential marker for the level of inflammation in cardiac disorders.

Should deep sedation be used during all catheter ablation procedures as a routine?: ÜREYEN et al.

We read with great interest the article of Münkler et al.1 entitled “High patient satisfaction with deep sedation for catheter ablation of cardiac arrythmia.” The aim of sedation is to decrease anxiety and to relieve pain which is related to the procedure. Administration of different levels of sedation is generally recommended during ablation procedures.2 Nevertheless, do all patients really need deep sedation in our daily practice, particularly patients undergoing supraventricular tachycardia ablation? Although cardiovascular functions are usually maintained during deep sedation, spontaneous ventilationmay sometimes be inadequate and an intervention to protect airway may sometimes be required.3 Moreover, research and audit demonstrate continued avoidable morbidity andmortality from sedationwhich is attributed to inadequacy of formal training for administration of sedative drugs and lack of prompt recognition and treatment of sedation-related complications.4 Furthermore, deep sedation may diminish inducibility of some arrythmias, particularly of catecholamine-sensitive ventricular tachycardias.2 In addition, routine deep sedation may result in high patient satisfaction, and on the other hand, it may increase the procedure time. Do authors have any data regarding this issue? To conclude, deep sedation can diminish patients’ perception of pain and discomfort. On the other hand, we should consider that we may increase the morbidity and possibly mortality as well as the procedure time and may decrease the inducibilty of some arrythmias, provided that we routinely administer deep sedation during catheter ablations.