Background: Dexmedetomidine (DEX) has both sedative and analgesic properties, and it does not suppress ventilation. This study investigated the safety and efficacy of DEX for sedation of RFA. Methods: This pilot study included 18 patients who received DEX during RFA; median age was 71 years (54-92). The initial loading dose of DEX was 1.5 or 3.0 μg/kg/hr for the initial 10 minutes, followed by 0.5 μg/kg/hr. Results: All 18 conscious patients had tolerated DEX with consciousness. All patients did not showed side effects except for 1 patient, who showed bradycardia but quickly recovered after administered 0.5 mg of atropine surface. Conclusions: It is likely that DEX during RFA is an effective and safe method of sedation in elderly patients.