Conscious sedation and anesthesia in the cardiac electrophysiology laboratory

Adequate anesthesia is important for performing EP procedures such as catheter ablation and implantation of cardiac devices. A wide range of anesthesia options are available, and all can be safely administered in EP laboratory with proper monitoring, drug selection, airway management equipment, and trained personnel. In addition to knowing the patient's clinical status, a thorough understanding of the clinical pharmacology of each anesthetic agent is essential in order to select appropriate drug among a variety of available anesthetics, to monitor for adverse effects, and to ensure adequate sedation and anesthesia for a comfortable, safe, and successful procedure. After a general strategy of anesthesia is planned, an individual anesthetic agent or combination of agents can be selected based on their pharmacological properties while keeping in mind the desired sedation/anesthesia requirements. Since anesthetics are often used in combination, the synergistic interaction of several anesthetic agents (infiltrative, parenteral, and/or inhaled) needs to be considered. Further attention also needs to be paid to the interaction between anesthetics and other existing medications. Finally, all care providers should work collaboratively and communicate frequently to provide a safe and effective anesthesia.