Interventional Electrophysiology [antikvár]

1 Organization of tlie Interventional Laboratory David E. Adams General Lab Requirements Personnel, equipment needs, types of studies, and facility construction must all be considered in organizing the intei"ven-tional laboratory for clinical electrophysiologic studies. Addressing these concerns will affect the safety, quahty, and efficiency of any study or procedure that is performed. Today's inteiventional laboratoiy must be set up to accommodate a variety of needs. These include conventional arrhythmia studies, ablation therapy, and device implantation. Certain aspects must be addressed regardless of the type of procedure being performed. Table 1.1 summarizes many of these common factors. Table 1.2 summarizes the North American Society of Pacing and Electrophysiology (NASPE) recommendations on cardiac ablation, especially those concerning personnel, facilities, and X-ray equipment (1). This set of guidelines is key to ensuring that cardiac ablations can be safely performed. Finally, the practitioner must understand some of the basic theory behind the technologies used in the interventional laboratory. This chapter addresses these points and explains the basic theories of the technologies involved. Staffing Requirements The most important aspect for performing safe, high-quality, and efficient studies is the presence of dedicated and adequately trained personnel. Also, the numbers of personnel present and the roles they perform directly affect the facility size and equipment that are needed. In most situations, two physicians are required. The first is the primary electrophysiologist, who oversees the procedure. The second is a physician or fellow, who manipulates catheters. Adequate monitoring allows both clinicians to follow catheter movement and the display of important data. Sedation of the patient is recommended, and a nurse