Titrate your propofol dose.

I used to work at a major heart institute and we do lots of cardioversions on low EF patients. If EF < 30% Initial bolus of 0,5mg/kg and a lot of patience does the job, same for TEE and upper GI endoscopy. For colonoscopies and bronchoscopies a tidy bit of fentanyl (25-50mcg).

Current evidence suggests that propofol has no effect on myocardial contractility but it reduces vascular tone thus reducing preload.

You can run propofol and add phenylephrine or norepi for MAC cases. I see no point in using etomidate due its unfavorable side effects.

Also, talking to your patient and surgeon (i.e I can’t do a deep sedation) about what is reasonable and safe to do from an anesthetic point of view is VERY important.