If anomalous conduction exits between atria and ventricles, that is an example of Wolf – Parkinson –White (WPW) Syndrome which is an anatomical reentry. Two pathways with different conduction velocities, initial pathway allows retrograde conduction while the other pathway is on refractory period. Reentry causes from an unexcitable area which is surrounded by an electrical pathway circle. Tachyarrhythmia originates with one of the three certain pathologic mechanisms the most common one is reentry mechanism, the others are increased automaticity in conduction cycle and triggered activity from another unusual cardiac focus. Those leads are helpful for planning the diagnosing and guiding strategy while ablation procedure is being performed.ĭifferent mechanisms induce arrhythmias, for example impairment of impulse generation causes bradyarrhythmias and sick sinus syndrome, sinus arrest, also deterioration of impulse propagation in the cardiac pathway systems known as atrioventricular node block brings indications for pacemakers. Intracardiac records obtain knowledge from high right atrium, coronary sinus, his bundle and right ventricular apex while extracardiac electrocardiography leads are I, II, III, aVL, V1 and V6. This article comprehensively reviews the anesthesia practice encountered in electrophysiology laboratories.Īn intracardiac demonstrates the electrical activity of heart with providing position and structure, voltage and duration of arrhythmia so as to certifying the accurate diagnosis. In this review, we aimed to describe the safe anesthesia methods in cardiac diagnostic procedures and have a closer look up the anesthetic outcomes of these procedures. The literature is still unclear about the effects of anesthetic agents on cardiac conduction pathways, but as we know with our previous data, the most agents we are using currently have more or less effect on the cardiac conduction systems. Meanwhile, with the exponential increase in interventional procedures in our decade, electrophysiologists’ need to cooperate with the anesthesiologists more frequently. In this environment, anesthesiology plays a very critical role to ensure patients comfort, as well as maintains operator’s convenience and facilitate management of undesired situations.ĮP laboratories are mostly used for diagnosis of certain heart diseases. Many clinical challenges have been encountered in electrophysiology laboratories (EP) while implanting intracardiac defibrillators for lethal arrhythmias, using pacemakers for bradyarrhythmias, placing pacemakers with multiple leads in patients with heart failure and cardiac ablation procedures.
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