Anesthetic Considerations in the Electrophysiology Laboratory: A Comprehensive Review.

Abstract

Catheter ablation procedures for arrhythmias or implantation and/or extraction of cardiac pacemakers can present many clinical challenges. It is imperative that there is clear communication and understanding between the anesthesiologist and electrophysiologist during the perioperative period regarding the mode of ventilation, hemodynamic considerations, and various procedural complications. This article provides a comprehensive narrative review of the anesthetic techniques and considerations for catheter ablation procedures, ventilatory modes using techniques such as high-frequency jet ventilation, and strategies such as esophageal deviation and luminal temperature monitoring to decrease the risk of esophageal injury during catheter ablation. Various hemodynamic considerations, such as the intraprocedural triaging of cardiac tamponade and fluid administration during catheter ablation, also are discussed. Finally, this review briefly highlights the early research findings on pulse-field ablation, a new and evolving ablation modality.

• Authors: Chikezie K Alvarez, Steven Zweibel, Alexander Stangle, Gregory Panza, Thomas May, Mark Marieb
• Journal: Journal of cardiothoracic and vascular anesthesia (J Cardiothorac Vasc Anesth) Vol. 37 Issue 1 Pg. 96-111 (01 2023) ISSN: 1532-8422 [Electronic] United States
• PMID: 36357307 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Chemical References

• Anesthetics

Topics

• Humans
• Anesthesia (adverse effects, methods)
• Catheter Ablation (adverse effects, methods)
• Anesthetics (adverse effects)
• Anesthesiologists
• Electrophysiology