Utility of High-frequency Jet Ventilation in Atrial Fibrillation Ablation

Abstract

Atrial fibrillation (AF) is the most common clinically significant arrhythmia that causes major morbidity and mortality. Catheter ablation focusing on pulmonary vein isolation is increasingly used for the treatment of symptomatic AF. Advances in ablation technologies and improved imaging and mapping have enhanced treatment efficiency but only modestly improved the efficacy. Another—but less commonly used—technology that can have a favorable impact involves enhancing the catheter–tissue contact by manipulating respiration to promote improved catheter stability and optimal contact. High-frequency jet ventilation (HFJV) is a mode of ventilation that can reduce respiratory movements to almost apneic conditions. In this review article, we aimed to highlight different studies, review the current literature regarding the utility of HFJV in AF ablation, and discuss the safety and efficacy of this approach relative to that of conventional ventilation.

Feasibility, Safety, and Short‐Term Outcomes of Transcatheter Patent Ductus Arteriosus Closure in Premature Infants on High‐Frequency Jet Ventilation

“…Studies that have appraised the safety and efficacy of this ventilation strategy in the catheterization laboratory have focused on adults undergoing electrophysiology procedures and have found it to be advantageous. 24 , 25 , 26 , 27 The proposed characteristics that lend themselves to making HFJV a successful ventilation strategy for electrophysiology procedures, namely, the low‐volume breaths that minimize respirophasic cardiac excursion 27 and potentially stabilize the heart, 24 , 28 could theoretically assist in transcatheter PDA closure and could, in part, explain the high success rate in our cohort. One would expect that such a stabilizing effect would be particularly important in infants with ELBW where PDA size can be exceptionally small.…”

Temporal trends in atrial fibrillation ablation procedures at an academic medical center: 2011−2021

“…An evolution in electrophysiology lab practice patterns was observed during the study period including a change from impedance to magnetic based EA mapping, adoption of jet ventilation, 11 irrigated, contact‐force ablation catheters, high‐powered short‐duration ablation lesions, 12 adoption of steady pacing, 13 and elimination of stepwise linear ablation strategy 14 (Figure 1E).…”

Patient-specific quantification of cardiorespiratory motion for cardiac stereotactic radioablation treatment planning

“…This assumption is supported by data on cardiac ablation in patients on jet ventilation vs intermittent positive pressure ventilation: jet ventilation virtually immobilizes the patients’ thorax, eliminating all breathing movements. 21 This ventilation method was shown in studies to significantly improve catheter stability and ablation outcomes, which was ascribed to reduced movement of the heart. 22 , 23 …”