The choice of general anesthetic for electrophysiological interventions on heart
Abstract
Introduction: One of the most common methods of treating arrhythmias is catheter ablation of the heart. A relevant issue is the choice of an anesthetic aid and a specific drug for anesthesia, taking into account the effect of anesthetics on hemodynamics and their possible arrhythmogenic effect.
Objective: to evaluate the benefits and limitations of various anesthesia techniques applied in catheter ablation procedures, according to data from the scientific literature.
Materials and methods: in this literature review we analyzed 37 scientific articles published in the open-access PubMed database from 2000 to 2025, focusing on anesthesia techniques used during catheter ablation of the heart — general anesthesia (GA), deep sedation (DS) and conscious sedation (CS).
Results: many researches demonstrate that GA/DS improve procedural success, reduce ablation time, and lower recurrence rates while maintaining comparable safety to CS. The benefits of GA/DS are attributed to better catheter stability and precision. The choice of anesthetics considers their hemodynamic and arrhythmogenic effects. Propofol is effective for DS but requires monitoring due to risks of hypotension and respiratory depression. Dexmedetomidine minimizes respiratory complications but may cause bradycardia. Benzodiazepines and opioids are suitable for moderate sedation, though their combination increases respiratory depression risks.
Conclusion: GA/DS is recommended for complex procedures (e.g., AF ablation), ensuring better outcomes, while CS may be used for simpler interventions. The choice of anesthetic should be tailored to the patient’s condition and procedural requirements.
Keywords
arrhythmia,
catheter ablation,
general anesthesia (GA),
deep sedation (DS),
choice of anesthetic drug
Supporting agencies: There was no sponsorship from companies.
About the Author
Andrey A. Vedernikov
FSBI “National Medical Research Center of Surgery named after A.V. Vishnevsky” of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Andrey A. Vedernikov - MD, Senior Researcher, Department of Anesthesiology, Resuscitation and Intensive Care
27, Bolshaya Serpukhovskaya Street, Moscow, 117997
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Review
For citations:
Vedernikov A.A. The choice of general anesthetic for electrophysiological interventions on heart. Minimally Invasive Cardiovascular Surgery. 2025;1(3):43-51. (In Russ.)
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