Airway Interventions in the Cardiac Electrophysiology Laboratory: A Retrospective Review

Ablação curativa da fibrilação atrial: comparação entre sedação profunda e anestesia geral

“…Hypoventilation may have occurred due to the central action of intravenous anesthetics, since the occurrence of upper respiratory obstruction was immediately treated with nasal and oropharyngeal cannulas. Trentman et al 19 , in a study of 208 patients undergoing various types of electrophysiological procedures under sedation, found that 40% of patients required some form of intervention in the upper airways, corroborating the results of this work. The arterial oxygen pressure and arterial oxygen saturation remained at normal levels and displayed the same behavior throughout the procedure for both groups, due to the greater provision of oxygen (O 2 ) supplied by the two techniques.…”

Impact of general anesthesia on initiation and stability of VT during catheter ablation

“…Without GA, deep sedation is often required for painful portions of the procedure potentially exposing the patient to the sequelae of hypercarbia, aspiration and large doses of drugs which have significant side effects with respect to recovery. One study 13 found that as many as 40% of adults undergoing RF catheter ablation under "sedation" reach deep sedation, essentially GA, at some point during the procedure, often without the benefit of a protected airway.…”

“…A number of studies 13 have shown that in adults and children, isoflurane, sevoflurane, desflurane, and intravenous agents including propofol have either minimal or no effects on cardiac electrophysiologic parameters. In the pediatric population radiofrequency ablation is typically performed under GA. A single prospective study 14 in this population found that both isoflurane and propofol based anesthesia were safe and did not effect inducibilty of supraventricular tachycardias.…”

Anaesthesiological support in a cardiac electrophysiology laboratory

“…Trentman et al 15 found a rate of airway complications of 40% in a cohort of patients undergoing sedation with fentanyl and midazolam or propofol. The lower rate of respiratory complications found in our study (19%) may be related to shorter procedure times (56 vs. 213 min) and to the choice of anaesthetic agents.…”