Anaesthesia for patients with arrhythmogenic right ventricular dysplasia

Table 1 Anaesthetic management of patients with arrhythmogenic right ventricular dysplasia

Preoperative management
History	Symptomatic arrhythmia, cardiac drug history, cardiology follow-up
Physical findings	Signs of systemic and pulmonary congestion
Specific diagnostic tests	ECG, Holter monitor, Echocardiography
Preoperative optimisation	Multidisciplinary approach involving cardiologist, surgeons, anaesthetists and intensivists
Intraoperative management
Monitoring	Minor surgical intervention: ECG, non-invasive blood pressure monitoring, SpO2, capnography Major surgical interventions: Central venous pressure, pulmonary artery catheter and cardiac output monitoring, temperature monitoring, intraoperative transoesophageal echocardiography
Haemodynamic stability	Maintaining adequate depth of anaesthesia and analgesia Adequate arterial perfusion pressure Avoiding tachycardia, bradycardia and arrhythmias Avoiding blood loss, hypovolaemia and fluid overload Maintaining adequate gas exchange Temperature control Electrolyte balance Acid-base balance
Choice of anaesthetic agents and vasoactive drugs	Understanding pharmacokinetics and side effects of the individual anaesthetic agents and anticipating cardiovascular effects
Postoperative management	Cardiovascular stability: Avoiding hypo- and hypertension, tachycardia, bradycardia and arrhythmias Prompt recognition of blood loss and hypovolaemia Normoxia and normocapnia Temperature control Adequate pain control Early treatment of postoperative nausea and vomiting Electrolyte and acid-base balance

ECG: Electrocardiogram.