EKTOPİK ODAK ABLASYONU YAPILAN HASTALARDA ANESTEZİ DERİNLİĞİNİN İŞLEM SÜRESİ VE BAŞARISI ÜZERİNE ETKİSİNİN İNCELENMESİ

Abstract

Electrophysiological study is an effective and reliable procedure for diagnosis, risk assessment, diagnosis and treatment of arrhythmias. In patients who will be ablation in electrophysiology laboratories, choosing an anesthesia method that will ensure the patient's adaptation to treatment, comfort and hemodynamic stability is very important for the success of the treatment. Although in previous years, ablation patients have been treated under deep sedation, in recent years, the general anesthesia method, which is a more reliable method in terms of patient comfort and stability of the procedure, is preferred. But the use of anesthetic agents can reduce the inducibility of arrhythmias and increase the need for hemodynamic support during the procedure. In our observational prospective study, we aimed to examine the effect of different BIS values on mapping time and process success by examining perioperative anesthesia records. After the approval of the ethics committee, the patients who underwent ectopic focal ablation under general anesthesia between December 2020 and April 2021 were checked for mapping time, duration of the procedure, ECG rhythm at the end of the procedure, the need for vasopressor or proarrhythmogenic agents during the procedure, and the ECG rhythm in the third month after the procedure. The effect of the depth of anesthesia according to patient’s BIS score on the success of the procedure was examined. As the depth of anesthesia increased, mapping time and processing time increased, and there was a significant difference between the two groups (p<0.001). No significant association was found between the depth of anesthesia and the need for proarithmogenic and vasopressor agents. As the depth of anesthesia increased, an increase in the incidence of arrhythmia was observed on the ECG taken at third-month controls after the procedure (p=0.006), but no significant difference was found between the two groups in terms of the need for ablation and the need for shock/cardioversion observed at third-month controls after the procedure. The process of ablation and split into subgroups according to the patients based on the depth of anesthesia when we compare; VT and AF ablation patients were examined and separated into two groups according to the depth of anesthesia, BIS value between 51 to 60, which is the second group, on average, mapping and the total processing time is shorter, and the lower the likelihood of arrhythmia was observed in the control of the third month, while the ablation depth of anaesthesia in patients at look at the difference in terms of the parameters was observed. In patients undergoing ectopic focus ablation under general anesthesia, it has been shown that the depth of anesthesia has a negative effect on the success of the procedure. This highly featured and work as a team and anesthesiologist at every stage of the application of elektrofizyolog considering the possibility that the initial focus of the mapping process is not found, this should be discussed with the patient before the procedure is likely and, if necessary, the reduction of the depth of anaesthesia monitoring in a controlled manner and under it, in a way that depends on the success of the process and we believe will further increase patient comfort and satisfaction.