Anesthetic Management and Considerations for Electrophysiology Procedures

Yang Gu; Heather L Lander; Ravie Abozaid; Francis M Chang; Hugo S Clifford; Mehmet K Aktas; Brandon F Lebow; Kunal Panda; Julie A Wyrobek

doi:10.1016/j.aan.2022.06.004

Anesthetic Management and Considerations for Electrophysiology Procedures

Adv Anesth. 2022 Dec;40(1):131-147. doi: 10.1016/j.aan.2022.06.004.

Authors

Yang Gu¹, Heather L Lander¹, Ravie Abozaid¹, Francis M Chang¹, Hugo S Clifford¹, Mehmet K Aktas², Brandon F Lebow¹, Kunal Panda¹, Julie A Wyrobek³

Affiliations

¹ Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine & Dentistry, 601 Elmwood Avenue, Box 604, Rochester, NY 14642, USA.
² Department of Medicine, Cardiology, University of Rochester School of Medicine & Dentistry, 601 Elmwood Ave, Floor G, Strong Ambulatory Care Facility, Rochester, NY 14642, USA.
³ Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine & Dentistry, 601 Elmwood Avenue, Box 604, Rochester, NY 14642, USA. Electronic address: Julie_Wyrobek@urmc.rochester.edu.

PMID: 36333043
DOI: 10.1016/j.aan.2022.06.004

Abstract

The number of electrophysiology (EP) procedures being performed has dramatically increased in recent years. This escalation necessitates a full understanding by the general anesthesiologist as to the risks, specific considerations, and comorbidities that accompany these now common procedures. Procedures reviewed in this article include atrial fibrillation and flutter ablation, supraventricular tachycardia ablation, ventricular tachycardia ablation, electrical cardioversion, pacemaker insertion, implantable cardioverter-defibrillator (ICD) insertion, and ICD lead extraction. General anesthetic considerations as well as procedure-specific concerns are discussed. Knowledge of these procedures will add to the anesthesiologist's armamentarium in safely caring for patients in the EP laboratory.

Keywords: Anesthesiology; Cardioversion; Catheter ablation; Electrophysiology laboratory; ICD lead extraction; Implantable cardioverter-defibrillator (ICD); Pacemaker.

Publication types

Review

MeSH terms

Anesthetics*
Atrial Fibrillation* / surgery
Cardiac Electrophysiology
Catheter Ablation* / methods
Defibrillators, Implantable*
Humans

Substances

Anesthetics