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

摘要

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.