Effects of Music During Atrial Fibrillation Ablation Under Conscious Sedation

Postoperative pain assessment is performed immediately following the ablation procedure using the modified Wong-Baker FACES Pain Rating Scale (scored 0-10, where higher scores indicate greater pain intensity), with patients instructed to select the facial expression corresponding to their peak intraoperative pain experience.

Anxiety levels are assessed using a shortened version of the original 20-item State-Trait Anxiety Inventory (the STAI-6, including three anxiety-present and anxiety-absent items, and each rated on a 4-point scale) at two time points: preoperatively (baseline) and immediately postoperatively (upon procedure completion).

Mean peak-to-peak interval of respiratory waveform.

Respiratory parameters are acquired through either:

• Built-in respiratory waveform of the 3D electroanatomical mapping system (e.g., EnSite™ or CARTO™), or
• Dedicated commercial respiratory monitoring devices (e.g., BioSignalPlux SOMNOtouch™ RESP), with signals synchronized to ablation timestamps.

Standard deviation(respiratory interval)/Mean(respiratory interval)×100%.

Respiratory parameters are acquired through either:

• Built-in respiratory waveform of the 3D electroanatomical mapping system (e.g., EnSite™ or CARTO™), or
• Dedicated commercial respiratory monitoring devices (e.g., BioSignalPlux SOMNOtouch™ RESP), with signals synchronized to ablation timestamps.

Standard deviation (respiratory waveform amplitude)/Mean(respiratory waveform amplitude)×100%.

Respiratory parameters are acquired through either:

• Built-in respiratory waveform of the 3D electroanatomical mapping system (e.g., EnSite™ or CARTO™), or
• Dedicated commercial respiratory monitoring devices (e.g., BioSignalPlux SOMNOtouch™ RESP), with signals synchronized to ablation timestamps.

Defined as ≥10-second cessation of breathing.

Respiratory parameters are acquired through either:

• Built-in respiratory waveform of the 3D electroanatomical mapping system (e.g., EnSite™ or CARTO™), or
• Dedicated commercial respiratory monitoring devices (e.g., BioSignalPlux SOMNOtouch™ RESP), with signals synchronized to ablation timestamps.

Definition: A measure of respiratory signal complexity where: Lower values (0-1) indicate regular breathing patterns; Higher values (>1.5) reflect irregularity (e.g., pain-induced variability).

Calculation Steps:

• Preprocess Signal

• Sample respiratory waveform at ≥100 Hz;
• Bandpass filter (0.1-1 Hz) to remove artifacts;
• Normalize to SD=1.
• Set Parameters:

• Embedding dimension (*m*)=2 (standard for physiologic signals);
• Tolerance (*r*)=0.2×SD (typically 0.1-0.25);
• Time series length (N)=200-500 breaths.
• Algorithm:

• Construct template vectors: Xm(i)=[u(i),u(i+1),...,u(i+m-1)];
• Count vector pairs where Chebyshev distance ≤ *r*:

B = matches for *m*-point vectors A = matches for (*m*+1)-point vectors;

• Compute:

Sample entropy =-ln(A/B).

Ablation time represents the sum of all radiofrequency application durations throughout the procedure, recorded in minutes

Defined as the proportion of left pulmonary veins achieving complete electrical isolation after initial circumferential ablation without touch-up lesions.

Defined as the proportion of Right pulmonary veins achieving complete electrical isolation after initial circumferential ablation without touch-up lesions.

Total intraoperative analgesic consumption is quantified as: Fentanyl equivalents (mcg/kg): Sum of bolus and maintenance doses

Number of supplemental dose administrations of analgesic drug.

The cumulative duration of X-ray exposure (in minutes) from first to last fluoroscopic activation, as automatically recorded by the angiography system.

Procedure-related adverse events are classified according to the 2023 HRS/EHRA/APHRS consensus statement:

Satisfaction levels are assessed using a 5-point Likert scale (1=very dissatisfied, 5=very satisfied)