Anesthetic management and outcomes in patients undergoing epicardial ablation for the treatment of ventricular tachycardia: A retrospective analysis

Ventricular arrhythmias are an important cause of morbidity and mortality, manifesting in various forms, ranging from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. General anesthesia provides advantages in terms of secured airway, increased patient comfort and satisfaction, and controlled respiration; however, its disadvantages are exacerbated by compromised cardiopulmonary function, typically requiring vasopressors and inotropic support. This study aimed to examine the anesthetic challenges and risk assessment in patients receiving epicardial ablation for ventricular tachycardia. In this retrospective, observational study, we collected data by examining the files of all patients who underwent percutaneous epicardial catheter ablation in our electrophysiology unit between October 30, 2020, and October 30, 2022, after obtaining ethics committee approval. All procedures were performed under general anesthesia. Midazolam, fentanyl, and low-dose propofol were used for induction. Maintenance was achieved using sevoflurane. The baseline characteristics of the patients and follow-up periods were recorded. Twenty patients were eligible for inclusion in the study. The mean age of the patients was 63.0 (57.5-66.0) years, 17 patients were male, and the mean body mass index was 25.9 (25.0-27.5) kg/m2. The mean American Society of Anesthesiologists physical status classification score was 4. Fourteen cases were evaluated as New York Heart Association classes III-IV. The mean left ventricular ejection fraction was 22.5% (16.5-43.0). Seventeen patients required dopamine, and cardiopulmonary resuscitation was performed in 1 patient. No procedure-related deaths were observed in any of the patients. Anesthesiologists and cardiologists should take a personalized approach to patient care, beginning with the preoperative process and continuing through the post-procedure period, ensuring good communication and collaborative planning.