Remifentanil–Midazolam Sedation Provides Hemodynamic Stability and Comfort During Epicardial Ablation of Ventricular Tachycardia

Authors


  • Jeff E. Mandel is a member of the speaker's bureau for Bioniche Pharma. Other authors: No disclosures.

Address for correspondence: Jeff E. Mandel, M.D., M.S., Department of Anesthesiology & Critical Care, 780B Dulles Building, 3400 Spruce Street, Philadelphia, PA 19104, USA. Fax: 215-615-3898; E-mail: mandelj@uphs.upenn.edu

Abstract

Remifentanil for Epicardial VT Ablation. Epicardial ablation of ventricular tachycardia (VT) presents multiple challenges for anesthetic management. General anesthesia lowers blood pressure, may interfere with arrhythmia mapping, and use of muscle relaxants precludes identification of the phrenic nerve. We describe a case in which remifentanil with minimal doses of midazolam was employed in a series of epicardial VT ablations and noninvasive programmed stimulations (NIPS), including 5 external cardioversions and discuss the advantages of this approach. (J Cardiovasc Electrophysiol, Vol. 22, pp. 464-466)

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