Lesion characteristics using high-frequency low-tidal volume ventilation versus standard ventilation during ablation of paroxysmal atrial fibrillation

Xiaoxiao Qian, Paul C. Zei, Jose Osorio, Daniela Hincapie, Mohamed Gabr, Adelqui Peralta, Andres F. Miranda-Arboleda, Bruce A. Koplan, Carolina Hoyos, Carlos D. Matos, Nestor Lopez-Cabanillas, Nathaniel A. Steiger, Alejandro Velasco, Isabella Alviz, Sunil Kapur, Thomas M. Tadros, Usha B. Tedrow, William H. Sauer, Jorge E. Romero

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: High-frequency low-tidal-volume (HFLTV) ventilation during radiofrequency catheter ablation (RFCA) for paroxysmal atrial fibrillation (PAF) has been shown to be superior to standard ventilation (SV) in terms of procedural efficiency, acute and long-term clinical outcomes. Our study aimed to compare ablation lesions characteristics utilizing HFLTV ventilation versus SV during RFCA of PAF. Methods: A retrospective analysis was conducted on patients who underwent pulmonary vein isolation (PVI) for PAF between August 2022 and March 2023, using high-power short-duration ablation. Thirty-five patients underwent RFCA with HFLTV ventilation and were matched with another cohort of 35 patients who underwent RFCA with SV. Parameters including ablation duration, contact force (CF), impedance drop, and ablation index were extracted from the CARTONET database for each ablation lesion. Results: A total of 70 patients were included (HFLTV = 35/2484 lesions, SV = 35/2830 lesions) in the analysis. There were no differences in baseline characteristics between the groups. While targeting the same ablation index, the HFLTV ventilation group demonstrated shorter average ablation duration per lesion (12.3 ± 5.0 vs. 15.4 ± 8.4 s, p <.001), higher average CF (17.0 ± 8.5 vs. 10.5 ± 4.6 g, p <.001), and greater impedance reduction (9.5 ± 4.6 vs. 7.7 ± 4.1 ohms, p <.001). HFLTV ventilation group also demonstrated shorter total procedural time (61.3 ± 25.5 vs. 90.8 ± 22.8 min, p <.001), ablation time (40.5 ± 18.6 vs. 65.8 ± 22.5 min, p <.001), and RF time (15.3 ± 4.8 vs. 22.9 ± 9.7 min, p <.001). Conclusion: HFLTV ventilation during PVI for PAF was associated with improved ablation lesion parameters and procedural efficiency compared to SV.

Original languageEnglish (US)
Pages (from-to)1962-1971
Number of pages10
JournalJournal of Cardiovascular Electrophysiology
Volume35
Issue number10
DOIs
StatePublished - Oct 2024

Keywords

  • ablation lesions characteristics
  • catheter ablation
  • high-frequency low-tidal volume ventilation
  • paroxysmal atrial fibrillation
  • pulmonary vein isolation
  • standard ventilation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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