• Alexander J C Mittnacht, Srinivas Dukkipati, and Aman Mahajan.
• From the *Department of Anesthesiology, and †Cardiovascular Institute, Mount Sinai Medical Center, The Icahn School of Medicine at Mount Sinai, New York, New York; and ‡Department of Anesthesiology, UCLA Perioperative Services, David Geffen School of Medicine at UCLA, Los Angeles, California.
• Anesth. Analg.. 2015 Apr 1;120(4):737-48.

AbstractPercutaneous catheter ablation is being increasingly performed in patients with recurrent ventricular tachycardia (VT) unresponsive to medical treatment. Optimal management of patients requires careful consideration of the severity of the underlying cardiac disease, the anesthetic drug interactions, and the procedural technique during VT mapping and ablation. The goal is to choose an anesthetic technique that has the least effect on arrhythmogenicity, allowing reproducibility of the VT in the electrophysiology laboratory. Anesthetics can alter action potential and ventricular depolarization directly through their effects on ion channels and gap junctions, as well as indirectly via their effects on the autonomic nervous system. Furthermore, maintaining hemodynamic stability and monitoring for adequate end-organ perfusion are additional challenges. In this review, we provide a comprehensive update on the currently performed VT ablation procedures and their anesthetic considerations.

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