The Electrophysiology Laboratory: Anesthetic Considerations and Staffing Models

The electrophysiology laboratory facilitates complex procedures on patients, many of whom have advanced disease processes and extensive comorbidities. Historically, nurses administered sedation as required, but in recent years a shift to anesthesiologist-led sedation has been promoted for patient safety and advanced therapeutic considerations. Uncertainty remains, however, regarding whether the electrophysiology laboratory is best staffed with general or cardiothoracic anesthesiologists. In this article, the authors discuss the anesthetic considerations of some commonly performed electrophysiology and structural cardiac procedures and the pros and cons of staffing with general or cardiothoracic anesthesiologists.