title: Isoproterenol infusion increases level of consciousness during catheter ablation of atrial fibrillation.
abstract: BACKGROUND
  The objective of this study was to determine the effects of isoproterenol infusion on level of consciousness during ablation using total intravenous anesthesia.
  
  
  RESULTS
  Seven patients undergoing total intravenous anesthesia for atrial fibrillation ablation were monitored for level of consciousness using bispectral EEG levels (BIS). Isoproterenol infusion was performed after the ablation during anesthesia. BIS levels prior to, during, and post-isoproterenol infusion were recorded and correlated to isoproterenol infusion doses. In all patients, BIS levels significantly increased during isoproterenol infusion (median BIS prior to infusion, 46; during infusion, 64 (p < 0.02)). With a subsequent increase in anesthetic medication, BIS levels could again be reduced.
  
  
  CONCLUSIONS
  Isoproterenol infusion alters consciousness level during total intravenous anesthesia for atrial fibrillation ablation. BIS monitoring is a novel way to modulate anesthesia during ablation to potentially optimize patient comfort and ablation success.
authors.affiliation: Department of Anesthesiology, NYU Langone Medical Center, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA. Daniel.ONeill@nyumc.org
authors.forename: Daniel K
authors.initials: DK
authors.lastname: O'Neill
authors.forename: Anthony
authors.initials: A
authors.lastname: Aizer
authors.forename: Patrick
authors.initials: P
authors.lastname: Linton
authors.forename: Marc
authors.initials: M
authors.lastname: Bloom
authors.forename: Emily
authors.initials: E
authors.lastname: Rose
authors.forename: Larry
authors.initials: L
authors.lastname: Chinitz
mesh_terms: D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003243:Consciousness / Q000187:drug effects*; D004569:Electroencephalography / Q000187:drug effects*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007545:Isoproterenol / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D010880:Piperidines / Q000008:administration & dosage*; D000077208:Remifentanil; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D007545:Isoproterenol; D000077208:Remifentanil