Remimazolam Besylate Versus Propofol for Procedural Sedation in Patients Undergoing Electrical Cardioversion: A Prospective, Noninferiority Cohort Study
Authors' conclusion
Remimazolam was associated with similar sedation adequacy but more favorable hemodynamics over time compared to propofol when used for procedural sedation in adults undergoing electrical cardioversion for atrial arrhythmias.
Study context
- Population
- Consecutive adults undergoing procedural sedation during electrical cardioversion for atrial fibrillation, tertiary university hospital electrophysiology department
- Participants
- 60 consecutive patients
- Exposure
- Remimazolam vs propofol for procedural sedation
- Remimazolamn = 30
- Propofoln = 30reference
- Outcome
- Time to loss of consciousness
Methodological detailsprespecified noninferiority analysis, single-centre
- Prespecified noninferiority analysis
- Single-centre
Main finding
As reported in the abstract
Mean difference in time to loss of consciousness between the groups (95% CI −0.38 to 1.20 minutes), within the noninferiority margin
0.41 minutes
Observational data: associations, not effects.
Further findings
Satisfactory sedation
Satisfactory sedation
- Similar between groups
BP indexes and oxygen saturation over the procedure
- Remimazolam significantly more favourable BP indexes but similar oxygen saturations vs propofol (linear mixed-effects model)
Safety
- Rescue ventilation required — Propofol
- 3 events
Original publication
Remimazolam Besylate Versus Propofol for Procedural Sedation in Patients Undergoing Electrical Cardioversion: A Prospective, Noninferiority Cohort Study. J Cardiothorac Vasc Anesth. Published 30 October 2025. doi:10.
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