COMPREHENSIVE ASSESSMENT OF VEGETATIVE AND NOCICEPTIVE STATUS IN PATIENTS WITH CARDIAC ARRHYTHMIAS

Area of Science:

• Cardiology
• Anesthesiology
• Neuroscience

Background:

• Anesthesia for cardiac rhythm disorder correction aims for patient comfort, ventilation, minimal movement, and catheter stability.
• Commonly used medications include hypnotics (propofol, midazolam) and analgesics (remifentanil, fentanyl), which minimally affect electrophysiological indicators.
• Increasing use of general anesthesia and deep sedation for complex arrhythmias raises concerns about anesthesia-related complications.

Purpose of the Study:

• To highlight the need for objective evaluation of anesthesia depth and analgosedation.
• To emphasize the development of multimodal monitoring for analgesia-nociception balance.
• To discuss methods for assessing periprocedural analgesia.

Main Methods:

• Meta-analysis of electrophysiological interventions.
• Systematic reviews of surgical interventions.
• Multimodal monitoring approaches analyzing autonomic nervous system activity (e.g., heart rate variability - HRV).
• Evaluation of electroencephalogram (EEG) and electromyogram (EMG) patterns.

Main Results:

• Hypnotics and analgesics minimally impact electrophysiological indicators, aiding mapping and ablation.
• Objective assessment of anesthesia depth is necessary due to procedure variability and patient pain thresholds.
• HRV, EEG, and EMG analysis offer objective periprocedural analgesia assessment.

Conclusions:

• Optimal anesthesia strategies are vital for cardiac rhythm disorder correction.
• Multimodal monitoring is essential for managing analgesia-nociception balance during complex procedures.
• Objective assessment methods like HRV, EEG, and EMG are key for safe and effective periprocedural care.