Anesthesia for Cardiac Ablation

Fujii, Satoru; Zhou, Jian; Dhir, Achal

doi:10.1053/j.jvca.2017.12.039

Cited by 11 publications

(24 citation statements)

References 170 publications

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“…RFCA is a well-described technique for treatment of tachyarrhythmias in humans, and was first described in the veterinary literature in dogs in the late 1980s. [3][4][5][6][7][8][9] RFCA is a nonpharmacological method of treating arrhythmias, which uses intracardiac catheters to deliver thermal energy to cardiac tissue, causing irreversible coagulation necrosis and nonconducting myocardial scarring in the identified area of aberrant conduction. [2][3][4][5] EAM of the cardiac chambers is required before ablation to visualise the activation pattern of the atria or ventricles.…”

Section: Discussionmentioning

confidence: 99%

“…7,[10][11][12] As procedures have become increasingly complex, and in an attempt to reduce radiation exposure, 3D EAM systems have been developed, which create visual 3D reconstructions of the cardiac chambers with their electrical activation pattern, without the need for fluoroscopy. 5,13 The mapping system tracks a catheter in the heart using impedance sensing or a magnetic sensor in combination with an external magnetic field generator to create a 3D image. 2,5 This development has enabled the ablation procedure to be adapted for use in the horse.…”

Section: Discussionmentioning

confidence: 99%

“…5,6,16,17 Propofol, alfentanil-midazolam, isoflurane, sevoflurane and desflurane have all been investigated in human patients undergoing the ablation procedures with minimal or no effect on cardiac electrophysiological parameters. 5,6,[15][16][17][18] Propofol and isoflurane-based techniques are the mainstay in paediatric anaesthesia for this type of intervention. 18 However, due to compliance with product licensing, cost and the potential for negatively impacting on quality of induction and recovery, pharmaceutical protocols for general anaesthesia in horses are relatively limited in comparison to human and small animal veterinary medicine.…”

Section: Discussionmentioning

confidence: 99%

“…24,29,35,36 Both agents prolong action potential duration, delay repolarisation and decrease inducibility of tachyarrhythmias. 5 However, these effects are minimal during ablation in humans with sevoflurane considered safe to use with no effect on electrophysiological parameters of the sinoatrial and atrioventricular nodes or the accessory pathways. 5 Isoflurane was the available inhalational agent of choice for the current case.…”

Section: Discussionmentioning

confidence: 99%

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Anaesthetic management for cardiac 3D electro‐anatomical mapping and radiofrequency catheter ablation in a horse with sustained atrial tachycardia

Phillips

Schauvliege

Decloedt

et al. 2022

Vet Record Case Reports

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Atrial arrhythmias in horses are common, and novel catheter-based treatment techniques require the horse to be under general anaesthesia. A 3-year-old gelding, weighing 517 kilograms, presented for cardiac three-dimensional electro-anatomical mapping and radiofrequency ablation for treatment of sustained atrial tachycardia. The current case report describes a suitable anaesthetic protocol that included medetomidine and methadone as premedication, a combination of ketamine and diazepam for coinduction of anaesthesia and maintenance with isoflurane vaporised in an oxygen/air mixture with constant-rate infusions of medetomidine and lidocaine. Total anaesthesia time was 205 minutes. The current protocol did not negatively impact on the procedure performed, provided good haemodynamic stability for several hours and enabled a smooth good-quality recovery. The horse developed a triceps myopathy postoperatively, which was successfully treated and the horse was discharged 18 days following treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Anaesthetic management for cardiac 3D electro‐anatomical mapping and radiofrequency catheter ablation in a horse with sustained atrial tachycardia

Phillips

Schauvliege

Decloedt

et al. 2022

Vet Record Case Reports

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“…AF inducibility and presence of extra-pulmonary (nonPV) foci may be suppressed in GA (ref. [8][9][10] ).…”

Section: Introductionmentioning

confidence: 99%

Atrial fibrillation inducibility after pulmonary vein isolation under general anaesthesia

Škála¹,

Tüdös²,

Moravec³

et al. 2020

BIOMED PAP

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Aims. Atrial fibrillation (AF) inducibil ity with rapid atrial pacing following AF ablation is associated with higher risk of AF recurrence. The predictive value of AF inducibility in paroxysmal AF patients after pulmonary vein isolation (PVI), done under general anaesthesia (GA), remains questionable since GA might alter AF inducibility and/or sustainability. Methods. Consecutive patients (n = 120) with paroxysmal AF without prior catheter ablation (CA) were enlisted in the study. All patients were ablated under GA. We have used a point-by-point CA and elimination of dormant conduction after adenosine in all patients. A predefined stimulation protocol was used to induce arrhythmias after PVI. Regular supraventricular tachycardias were mapped and ablated. Patients were divided into 3 subgroups-noninducible, inducible AF with spontaneous termination in five minutes, inducible AF without spontaneous termination. During 12 months of follow-up, all patients were examined four-times with 7-day ECG recordings. Results. There was no statistical difference between the three subgroups in a rate of arrhythmia recurrence (11.1 vs. 27.5 vs. 27.3%, P=0.387), despite a clear trend to a better success rate in the non-inducible group. The subgroups did not differ in left atrial (LA) diameter (41.0±6, 43.0±7, 42.0±5 mm, P=0.962) or in any other baseline parameter. Conclusion. AF inducibility as well as presence or absence of its early spontaneous termination after PVI done under general anaesthesia in paroxysmal AF patients were not useful as predictors of procedural failure.

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Non-Operating Room Anesthesia for Electrophysiology Procedures

Martin

Cheng

2020

Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery

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Anesthesia for Cardiac Ablation

Cited by 11 publications

References 170 publications

Anaesthetic management for cardiac 3D electro‐anatomical mapping and radiofrequency catheter ablation in a horse with sustained atrial tachycardia

Anaesthetic management for cardiac 3D electro‐anatomical mapping and radiofrequency catheter ablation in a horse with sustained atrial tachycardia

Atrial fibrillation inducibility after pulmonary vein isolation under general anaesthesia

Non-Operating Room Anesthesia for Electrophysiology Procedures

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