Ventricular Tachycardia
Conditions
Keywords
anesthesia, ventricular tachycardia, Electrophysiology, electro-anatomic mapping, catheter ablation, risk assessment
Brief summary
The study is a retrospective study and is descriptive in nature. In this study, the investigators aimed to emphasize the importance of anesthesia management by cardiac risk assessment of patients undergoing epicardial ablation under general anesthesia and analysis of complications that developed during the procedure.
Detailed description
The study is retrospective observational and data were collected by examining the files of all epicardial ablation patients received in the angiography unit starting from 30.10.2020 until 30.10.2022 after ethics committee approval is obtained. Baseline characteristic features of the patients Sex, Age, (years, BMI (kg/m2) Hypertension, Coronary artery disease, COPD (Chronic obstructive pulmonary disease), CKD (Chronic kidney disease) Electrical storm, and ventricular tachycardia etiology, Ischemic cardiomyopathy, Dilated cardiomyopathy, the presence of ARVC (Arrhythmogenic Right Ventricular Cardiomyopathy), Hypertrophic cardiomyopathy will be recorded. NHYA classification will be examined in two groups as NHYA I or II and NHYA III or IV, also estimated glomerular filtration rate, left ventricular ejection fraction, PAAINESD (acute hemodynamic decompensation risk assessment score), iVT score (Risk of VT recurrence) Score information will be recorded. Ventricular tachycardia focus locations, dopamine, dobutamine, norepinephrine infusion requirement during the procedure, arrest development during the procedure, fluoroscopy time and ablation times will be recorded. In the follow-up of the patients after the procedure Causes of death, decompensated heart failure, transient ischemic attack, development of acute renal failure, and recurrence of ventricular tachycardia will be recorded. PAAINESD score (acute hemodynamic decompensation risk assessment score) will be recorded. The PAAINESD Score, developed to estimate the risk of periprocedural hemodynamic decompensation, has values ranging from 0 to 35 points (or 0 to 31 \[PAINESD\] when the modifiable intraprocedural variable general anesthesia is excluded). duration of the procedure, the need for inotropes during the procedure, whether the patient needed mechanical ventilation after the procedure, and the success rates after the procedure will be recorded. PAINESD Pulmonary disease (chronic obstructive pulmonary disease) 5 Age \>60 years 3 Anaesthesia (general) 4 Ischaemic cardiomyopathy 6 NYHA class III or IV 6 Ejection fraction \<25 % 3 Storm (VT). 5 Diabetes 3 Data will be analyzed in three separate categories, the characteristics of the patients before the procedure, during the procedure and after the procedure. Descriptive tables and percentages of parameters will be created by statistical analysis.
Interventions
Epicardial catheter ablation is often necessary for the successful treatment of scar-induced ventricular tachycardia (VT), especially in patients with nonischemic cardiomyopathy (NICMP) where scarring is more extensive on the mid-myocardial or epicardial surface. Because epicardial mapping can be painful and patient movement can limit mapping and safe epicardial access, a common strategy for these patients is general anesthesia.
Sponsors
Study design
Eligibility
Inclusion criteria
• age \> 18 years old who underwent elective VT ablation between 2020 - 2022, * primary anesthetic type listed as general anesthesia
Exclusion criteria
• age \< 18 years, * missing follow-up data, * patients who have previously undergone epicardial ablation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ablation time | 2 years | minutes |
| glomerular filtration rate (eGFR) | 2 years | ml/dak/1,73m2 |
| Total procedural time | 2 years | minutes |
| Fluoroscopy time | 2 years | minutes |
| sex | 2 years | male % |
| age | 2 years | years |
| weight | 2 years | kilograms |
| height | 2 years | meters |
| Hypertension | 2 years | yes or no |
| Diabetes mellitus | 2 years | yes or no |
| Coronary artery disease | 2 years | yes or no |
| Chronic obstructive pulmonary disease | 2 years | yes or no |
| Chronic kidney disease | 2 years | yes or no |
| Systolic pulmonary artery pressure | 2 years | mmHg |
| Left ventricular ejection | 2 years | % |
| PAAINESD (Acute hemodynamic decompensation risk assessment, ranging from 0 to 35 points, 35 point is the worst) score | 2 years | score 0-35 |
| ASA ( American Society of Anesthesiologists (ASA) physical status classification ranging from I to IV | 2 years | score I-IV |
| Hemoglobin | 2 years | g/dl |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Exitus during the follow-up | 2 years | yes or no |
| cause of death | 2 years | End-Stage heart failure, VT storm |
| Transient ischemic attack after procedure | 2 years | yes or no |
Countries
Turkey (Türkiye)