The effect of anesthesia depth on radiofrequency catheter ablation of
ventricular tachycardia: a retrospective cohort study
Abstract
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. However, the procedure and prognosis may be affected
by the use of anesthetics. Objectives: 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 performed a retrospective study
of all patients with a confirmed diagnosis of VT and underwent RFCA by
general anesthesia from January 2014 to March 2019. According to
intraoperative VT induction, they were divided into 2 groups:
non-inducible group and inducible group. We constructed several
multivariable regression models, in which covariates included patient
characteristics, comorbidities, protopathy and BIS value. Results:
We included 101 patients, 29 (28.7%) of whom experienced VT no
induction, and 26 (26.3%) recurrence within one year. 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). Conclusions: This study reported lower
BIS value during VT induction was associated with high risk of the
failure of VT induction, which in turn affects postoperative outcomes.
We propose that appropriate depth of anesthesia should be maintained
during the process of VT induction.