Key result
A bispectral index (BIS) value <40 during general anesthesia was associated with significantly elevated odds of ventricular tachycardia non-induction compared to a BIS >50 (OR 6.92).
Why the study?
The effects of different anesthetic depths on perioperative radiofrequency catheter ablation and recurrence in patients with intractable VT unable to tolerate an awake procedure were not well defined.
Does deep anesthesia (BIS <40) reduce the inducibility of ventricular tachycardia during radiofrequency catheter ablation in adults?
Observational (n=101)
No
Does deep anesthesia (BIS <40) reduce the inducibility of ventricular tachycardia during radiofrequency catheter ablation in adults?
Deeper anesthesia (BIS <40) during VT ablation is associated with failure to induce VT, which in turn strongly predicts VT recurrence within one year.
Answers are grounded in this paper and cite their sources.
Deep anesthesia (BIS <40) may impede VT induction during ablation; leaves open whether BIS-guided depth affects recurrence.
Background: Radiofrequency catheter ablation (RFCA) as a safe and effective method has been widely used in ventricular tachycardia (VT) patients, and with which anesthesiologists frequently manage their perioperative care. The aim of this study was to investigate the effects of different anesthetic depths on perioperative RFCA and recurrence in patients who with intractable VT and could not tolerate an awake procedure.Methods: We reviewed electronic medical records of patients with VT who underwent RFCA by general anesthesia from January 2014 to March 2019. According to intraoperative VT induction, they were divided into two groups: non-inducible group (group N) and inducible group (group I). We constructed several multivariable regression models, in which covariates included patient characteristics, comorbidities, protopathy and BIS value. Results: 101 patients were analyzed. 29 patients (28.7%) experienced VT no induction, and 26 patients (25.7%) recurrented within one year. Compared with group I, the proportion of patients with arrhythmogenic right ventricular cardiomyopathy in group NI were higher (P<0.05), and the recurrence rate of VT was significantly higher (51.7% vs 15.3%) (P<0.05). Based on pre-specified bispectral index (BIS), the BIS <40 was associated with elevated odds of VT no induction compared with a BIS value >50 (odds ratio, 6.92; 95% confidence interval, 1.47-32.56; P=0.01). VT no induction was an independent predictor of recurrence after RFCA (odds ratio, 5.01; 95% confidence interval, 1.88-13.83; P<0.01).Conclusion: Lower BIS value during VT induction in RFCA operation was associated with high risk of VT no induction, which affects postoperative outcomes. We proposed that appropriate depth of anesthesia should be maintained during the process of VT induction.Trial registrationChiCTR, ChiCTR2000034210. Registered 28 June 2020 - Retrospectively registered, http://www.chictr.org.cn/edit.aspx?pid=55691&htm=4
No takes yet. Share an insight, caveat, or question.
Dong et al. (2020) conducted an observational in Ventricular tachycardia (n=101). Bispectral index (BIS) < 40 vs. BIS > 50 was evaluated on Ventricular tachycardia non-induction (OR 6.92, 95% CI 1.47-32.56, p=0.01). A bispectral index (BIS) value <40 during general anesthesia was associated with significantly elevated odds of ventricular tachycardia non-induction compared to a BIS >50 (OR 6.92).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: