Continuous transcutaneous carbon-dioxide monitoring to avoid hypercapnia in complex catheter ablations under conscious sedation

Ablation of complex cardiac arrhythmias requires an immobilized patient. For a successful and safe intervention and for patient comfort, this can be achieved by conscious sedation. Administered sedatives and analgesics have respiratory depressant side effects and require close monitoring. We investigated the feasibility and accuracy of additional, continuous transcutaneous carbon-dioxide partial pressure (tpCO2) measurement during conscious sedation in complex electrophysiological catheter ablation procedures. We evaluated the accuracy and additional value of continuous tpCO2 detection by application of a Severinghaus electrode in comparison to arterial and venous blood gas analyses. We included 110 patients in this prospective observational study. Arterial pCO2 (paCO2) and tpCO2 showed good correlation throughout the procedures (r = 0.60–0.87, p