Key result
Remifentanil with minimal doses of midazolam provided hemodynamic stability and comfort during epicardial ablation of ventricular tachycardia and noninvasive programmed stimulations.
Case Report (n=1)
Remifentanil-midazolam sedation may offer a hemodynamically stable alternative to general anesthesia for epicardial VT ablation, facilitating arrhythmia mapping and phrenic nerve identification.
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May support remifentanil-midazolam sedation for epicardial VT ablation; leaves open randomized comparison to general anesthesia.
Epicardial ablation of ventricular tachycardia (VT) presents multiple challenges for anesthetic management. General anesthesia lowers blood pressure, may interfere with arrhythmia mapping, and use of muscle relaxants precludes identification of the phrenic nerve. We describe a case in which remifentanil with minimal doses of midazolam was employed in a series of epicardial VT ablations and noninvasive programmed stimulations (NIPS), including 5 external cardioversions and discuss the advantages of this approach.
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Mandel et al. (2010) conducted a case report in Ventricular tachycardia (n=1). Remifentanil with minimal doses of midazolam was evaluated. Remifentanil with minimal doses of midazolam provided hemodynamic stability and comfort during epicardial ablation of ventricular tachycardia and noninvasive programmed stimulations.
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