• Rachel S Dada, Joseph A McGuire, HayangaJ W AworiJWADepartment of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV., Dylan Thibault, David Schwartzman, Matthew Ellison, and Heather K Hayanga.
• Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, OH.
• J. Cardiothorac. Vasc. Anesth. 2024 Mar 1; 38 (3): 675682675-682.

ObjectivesThe authors analyzed anesthetic management trends during ventricular tachycardia (VT) ablation, hypothesizing that (1) monitored anesthesia care (MAC) is more commonly used than general anesthesia (GA); (2) MAC uses significantly increased after release of the 2019 Expert Consensus Statement on Catheter Ablation of Ventricular Arrhythmias; and (3) anesthetic approach varies based on patient and hospital characteristics.DesignRetrospective study.SettingNational Anesthesia Clinical Outcomes Registry data.ParticipantsPatients 18 years or older who underwent elective VT ablation between 2013 and 2021.InterventionsNone.Measurements And Main ResultsCovariates were selected a priori within multivariate models, and interrupted time-series analysis was performed. Of the 15,505 patients who underwent VT ablation between 2013 and 2021, 9,790 (63.1%) received GA. After the 2019 Expert Consensus Statement on Catheter Ablation of Ventricular Arrhythmias supported avoidance of GA in idiopathic VT, no statistically significant increase in MAC was evident (immediate change in intercept post-consensus statement release adjusted odds ratio 1.41, p = 0.1629; change in slope post-consensus statement release adjusted odds ratio 1.06 per quarter, p = 0.1591). Multivariate analysis demonstrated that sex, American Society of Anesthesiologists physical status, age, and geographic location were statistically significantly associated with the anesthetic approach.ConclusionsGA has remained the primary anesthetic type for VT ablation despite the 2019 Expert Consensus Statement on Catheter Ablation of Ventricular Arrhythmias suggested its avoidance in idiopathic VT. Achieving widespread clinical practice change is an ongoing challenge in medicine, emphasizing the importance of developing effective implementation strategies to facilitate awareness of guideline release and subsequent adherence to and adoption of recommendations.Copyright © 2023. Published by Elsevier Inc.

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