Anesthetic management of patients undergoing pulmonary vein isolation for treatment of atrial fibrillation using high-frequency jet ventilation.

OBJECTIVES

The aim of this study was to describe anesthetic management and perioperative complications in patients undergoing pulmonary vein isolation for the treatment of atrial fibrillation under general anesthesia using high-frequency jet ventilation. The authors also identified variables associated with longer ablation times in this patient cohort.

DESIGN

A retrospective observational study.

SETTING

The electrophysiology laboratory in a major university hospital.

PARTICIPANTS

One hundred eighty-eight consecutive patients undergoing pulmonary vein isolation under general anesthesia with high-frequency jet ventilation.

INTERVENTIONS

High-frequency jet ventilation was used as the primary mode of ventilation under general anesthesia.

MEASUREMENTS AND MAIN RESULTS

High-frequency jet ventilation was performed successfully throughout the ablation procedure in 175 cases of the study cohort. The remaining 13 patients had to be converted to conventional positive-pressure ventilation because of high PaCO(2) or low PaO(2) on arterial blood gas measurements. Variables associated with a shorter ablation time included a higher ejection fraction (p = 0.04) and case volume performed by each electrophysiologist in the study group (p = 0.001).

CONCLUSIONS

High-frequency jet ventilation is generally a safe technique that can be used in catheter ablation treatment under general anesthesia.