Effects of dexmedetomidine-remifentanil on hemodynamics and inflammatory responses in patients undergoing atrial fibrillation ablation.

This randomized controlled trial evaluated dexmedetomidine combined with remifentanil versus remifentanil alone for monitored anesthesia care during radiofrequency catheter ablation for atrial fibrillation. Between January and December 2023, 100 patients were stratified by age, sex, BMI, and atrial fibrillation type, then randomly assigned (1:1, block size 4, sealed envelopes) to Group A (dexmedetomidine 1 μg/kg loading then 0.2-0.4 μg/kg/h plus remifentanil, n = 50) or Group B (saline control plus remifentanil, n = 50). Baseline characteristics were comparable (all P > 0.05). Hemodynamic parameters were recorded at baseline (T 0), 10 min after induction (T 1), maintenance (T 2), 10 min before surgery end (T 3), and at surgery end (T 4). Group A showed higher mean arterial pressure, cardiac index, and cardiac output at T 1-T 4 (P < 0.05), with lower heart rate and blood pressure (P < 0.05). Ramsay Sedation Score was higher at T 3-T 4 (P < 0.05). Adverse reactions and inflammatory markers (IL-6, TNF-α, CRP) were attenuated postoperatively (P < 0.05). Dexmedetomidine combined with remifentanil provides superior hemodynamic stability, enhanced sedation, reduced inflammation, and fewer adverse events during atrial fibrillation ablation.