Health & Medical Heart Diseases

Safe Sedation in Modern Cardiological Practice

Safe Sedation in Modern Cardiological Practice

Background to Safe Sedation in Modern Cardiological Practice


The Academy of Medical Royal Colleges has produced new guidance on safe sedation in the UK. This document updated the 2001 document that has shaped UK sedation practice for some time and focused particularly on issues that have arisen in dental and gastroenterological practice but has huge implications for cardiological practice.

The key Academy recommendations are as follows:

  1. Sedation should be based on competencies defined for each specialty.

  2. Continuing training and demonstration of relevant continuing professional development (CPD) should be performed and relate to revalidation.

  3. Sedation outcomes should be patient-centred and audited.

  4. Trusts should establish sedation committees to oversee training and monitor training in sedation.

  5. Sedation teams (akin to pain teams) should be established.

  6. The standards should apply in primary care and private healthcare as well as National Health Service trusts.

Sedation is fundamental for many cardiological procedures particularly in the arena of arrhythmia management. The environment for cardiological sedation varies internationally and is very different from many other situations such as dental and gastrointestinal (GI) practice, and a large number of cardiac procedures that involve sedation are performed annually.

This report is produced by consensus mainly by the Academy Committee member (SSF) who represented the British Cardiovascular Society (BCS) and the British Heart Rhythm Society (BHRS), with support from the Academy Committee chair (JRS) after consultation with BCS and BHRS members.

Cardiological procedures involving sedation fall into five main areas:

  1. cardioversion of atrial fibrillation (AF)/atrial flutter/stable ventricular tachycardia

  2. catheter ablation of AF and other arrhythmias

  3. transoesophageal echocardiography (TOE)

  4. cardiovascular implantable electronic devices (CIEDs)

  5. other diagnostic or interventional procedures, for example, transcatheter aortic valve replacement (TAVR).



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