Key result
Anesthetic management during ventricular tachycardia ablation requires balancing hemodynamic stability with minimizing effects on arrhythmogenicity to allow reproducible VT mapping.
This review provides a comprehensive update on currently performed VT ablation procedures and their anesthetic considerations.
Anesthetic strategies in VT ablation should prioritize individualized hemodynamic and electrophysiologic balance; leaves open the need for prospective trials to guide agent selection.
Percutaneous catheter ablation is being increasingly performed in patients with recurrent ventricular tachycardia (VT) unresponsive to medical treatment. Optimal management of patients requires careful consideration of the severity of the underlying cardiac disease, the anesthetic drug interactions, and the procedural technique during VT mapping and ablation. The goal is to choose an anesthetic technique that has the least effect on arrhythmogenicity, allowing reproducibility of the VT in the electrophysiology laboratory. Anesthetics can alter action potential and ventricular depolarization directly through their effects on ion channels and gap junctions, as well as indirectly via their effects on the autonomic nervous system. Furthermore, maintaining hemodynamic stability and monitoring for adequate end-organ perfusion are additional challenges. In this review, we provide a comprehensive update on the currently performed VT ablation procedures and their anesthetic considerations.
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Mittnacht et al. (2015) conducted a review in recurrent ventricular tachycardia. Ventricular tachycardia ablation and anesthetic management was evaluated. Anesthetic management during ventricular tachycardia ablation requires balancing hemodynamic stability with minimizing effects on arrhythmogenicity to allow reproducible VT mapping.
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