Every year, 80,000–100,000 ablation procedures take place in the United States and approximately 1% of these involve paediatric patients. As the paediatric population undergoing catheter ablation to ...treat dysrhythmia is constantly growing, involvement of anaesthesiologists in the cardiac electrophysiology laboratory is simultaneously increasing. Compared with the adult population, paediatric patients need deeper sedation or general anaesthesia (GA) to guarantee motionlessness and preserve comfort. As a result, the anaesthesiologist working in this setting should keep in mind heart physiopathology as well as possible interactions between anaesthetic drugs and arrhythmia. In fact, drug-induced suppression of accessory pathways (APs) conduction capacity is a major concern for completing a successful electrophysiology study (EPS). Nevertheless, the literature on this topic is scarce and the optimal type of anaesthesia in EPS and ablation procedures in children is still controversial. Thus, the main goal of the present review is to collect the literature published so far on the effects on cardiac conduction tissue of the drugs commonly employed for sedation/GA in the cath lab for EPS and ablation procedures to treat supraventricular tachycardia in patients aged <18 years.
•Anaesthetics can influence procedural outcomes by potentially affecting arrhythmia inducibility.•Tailoring the anaesthetic plan to each patient is crucial to achieving successful arrhythmia ablation.•Children exhibit unique characteristics that cannot be directly extrapolated from the adult population.•While general anaesthesia is largely adopted in elethrophisiology procedures it may affect procedural outcomes.•Future studies should compare general anaesthesia vs. sedation in terms of successful arrhythmia ablation and safety.
