Yildiz Mustafa, Yilmaz Ak Hulya, Oksen Dogac, Oral Sinan
Department of Cardiology.
Anesthesiology and Reanimation, Istanbul University Cardiology Institute, Istanbul, Turkey.
J Atr Fibrillation. 2018 Feb 28;10(5):1775. doi: 10.4022/jafib.1775. eCollection 2018 Feb.
Many clinical challenges have been encountered in electrophysiology laboratories (EP) while implanting intracardiac defibrillators for lethal arrhythmias, using pacemakers for bradyarrhythmias, placing pacemakers with multiple leads in patients with heart failure and cardiac ablation procedures. In this environment, anesthesiology plays a very critical role to ensure patients comfort, as well as maintains operator's convenience and facilitate management of undesired situations. EP laboratories are mostly used for diagnosis of certain heart diseases. Meanwhile, with the exponential increase in interventional procedures in our decade, electrophysiologists' need to cooperate with the anesthesiologists more frequently. The literature is still unclear about the effects of anesthetic agents on cardiac conduction pathways, but as we know with our previous data, the most agents we are using currently have more or less effect on the cardiac conduction systems. In this review, we aimed to describe the safe anesthesia methods in cardiac diagnostic procedures and have a closer look up the anesthetic outcomes of these procedures. This article comprehensively reviews the anesthesia practice encountered in electrophysiology laboratories.
在心脏电生理实验室(EP)中,在为致命性心律失常植入心内除颤器、为缓慢性心律失常使用起搏器、为心力衰竭患者植入多根导线的起搏器以及进行心脏消融手术时,会遇到许多临床挑战。在这种环境下,麻醉学起着非常关键的作用,以确保患者舒适,同时保持操作者的便利性并便于处理意外情况。EP实验室主要用于某些心脏病的诊断。与此同时,在过去十年中,介入手术呈指数级增长,电生理学家需要更频繁地与麻醉师合作。关于麻醉剂对心脏传导通路的影响,文献中仍不明确,但根据我们之前的数据可知,我们目前使用的大多数药物或多或少都会对心脏传导系统产生影响。在这篇综述中,我们旨在描述心脏诊断程序中的安全麻醉方法,并更深入地了解这些程序的麻醉效果。本文全面回顾了心脏电生理实验室中遇到的麻醉实践。