Anesthetic Management of Patients Undergoing Pulmonary Vein Isolation for Treatment of Atrial Fibrillation Using High-Frequency Jet Ventilation

作者：Elkassabany Nabil^*; Garcia Fermin; Tschabrunn Cory; Raiten Jesse; Gao William; Chaichana Khan; Dixit Sanjay; Speck Rebecca M; Zado Erica; Marchlinski Francis; Mandel Jeff

来源：Journal of Cardiothoracic and Vascular Anesthesia, 2012, 26(3): 433-438.

DOI：10.1053/j.jvca.2011.11.011

• high-frequency jet ventilation
• atrial fibrillation
• catheter ablation
• pulmonary vein isolation
• general anesthesia

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 PaCO2 or low PaO2 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.

• 出版日期2012-6