Academic Journal
Influence of High-Frequency Low-Tidal Volume Versus Jet Ventilation on Acute and Long-Term Outcomes Following Pulmonary Vein Isolation.
| Τίτλος: | Influence of High-Frequency Low-Tidal Volume Versus Jet Ventilation on Acute and Long-Term Outcomes Following Pulmonary Vein Isolation. |
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| Συγγραφείς: | Villarreal D; Harvard-Thorndike Arrhythmia Institute, Beth Israel Deaconess Medical Center, Division of Cardiovascular Medicine, Boston, Massachusetts, USA., Perez-Pinzon J; Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA., d'Avila A; Harvard-Thorndike Arrhythmia Institute, Beth Israel Deaconess Medical Center, Division of Cardiovascular Medicine, Boston, Massachusetts, USA., Zimetbaum P; Harvard-Thorndike Arrhythmia Institute, Beth Israel Deaconess Medical Center, Division of Cardiovascular Medicine, Boston, Massachusetts, USA., Locke AH; Harvard-Thorndike Arrhythmia Institute, Beth Israel Deaconess Medical Center, Division of Cardiovascular Medicine, Boston, Massachusetts, USA., Yang S; Harvard-Thorndike Arrhythmia Institute, Beth Israel Deaconess Medical Center, Division of Cardiovascular Medicine, Boston, Massachusetts, USA., Maher T; Harvard-Thorndike Arrhythmia Institute, Beth Israel Deaconess Medical Center, Division of Cardiovascular Medicine, Boston, Massachusetts, USA., Sehgal S; Department of Anesthesiology, Boston Medical Center, Boston, Massachusetts, USA., Schaeffer MS; Department of Anesthesia & Critical Care, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.; Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Sahli SD; Department of Anesthesia & Critical Care, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.; Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Waks JW; Harvard-Thorndike Arrhythmia Institute, Beth Israel Deaconess Medical Center, Division of Cardiovascular Medicine, Boston, Massachusetts, USA., Tung P; Harvard-Thorndike Arrhythmia Institute, Beth Israel Deaconess Medical Center, Division of Cardiovascular Medicine, Boston, Massachusetts, USA. |
| Πηγή: | Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2026 Sep; Vol. 37 (9), pp. 1921-1929. Date of Electronic Publication: 2026 Jun 30. |
| Τύπος έκδοσης: | Journal Article; Comparative Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Blackwell Country of Publication: United States NLM ID: 9010756 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8167 (Electronic) Linking ISSN: 10453873 NLM ISO Abbreviation: J Cardiovasc Electrophysiol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Malden, MA : Blackwell Original Publication: Mt. Kisco, N.Y. : Futura Pub., c1990- |
| Ιατρικοί όροι (MeSH): | Pulmonary Veins*/surgery , Pulmonary Veins*/physiopathology , High-Frequency Jet Ventilation*/adverse effects , Atrial Fibrillation*/surgery , Atrial Fibrillation*/physiopathology , Atrial Fibrillation*/diagnosis , Catheter Ablation*/adverse effects , Tidal Volume*, Humans ; Female ; Time Factors ; Male ; Risk Factors ; Aged ; Middle Aged ; Progression-Free Survival ; Treatment Outcome ; Action Potentials ; Prospective Studies ; Recurrence |
| Περίληψη: | Introduction: Use of high-frequency low-tidal volume (HFLTV) and high-frequency jet ventilation (HFJV) during pulmonary vein isolation (PVI) improves acute procedural success and long-term outcomes compared to conventional ventilation. However, the impact of HFLTV compared to HFJV on acute and long-term outcomes is unknown. Methods: We prospectively identified 1039 patients who underwent first-time PVI or PVI with posterior wall isolation (PWI) at our institution between 2022 and 2024 with HFLTV or HFJV. Acute procedural and safety outcomes were analyzed. Twelve-month arrhythmia-free survival was evaluated using the Kaplan-Meier and Cox proportional hazards method. Results: After excluding 44 patients who required discontinuation of HFJV, 860 patients receiving HFJV were compared with 179 receiving HFLTV ventilation. Mean age was 65 years, 93% were White, 30% female and 53% had paroxysmal AF. First-pass isolation (FPI) rates were similar between ventilation strategies. HFLTV was associated with a higher rate of intraprocedural hypotension (31% vs 23%, p = 0.02). Complications were generally minor and comparable between groups. Arrhythmia recurrence rates at 12 months were similar (HR: 0.89, p = 0.55). There was a trend toward improved outcomes when FPI was achieved for both pulmonary veins in either group. Conclusion: In this observational cohort, no significant differences in acute procedural outcomes, safety outcomes, or long-term arrhythmia recurrence were observed between HFLTV and HFJV. Given the specialized equipment and operator training required for HFJV and its non-negligible rate of discontinuation, HFLTV may offer a modest practical advantage in routine clinical practice. (© 2026 Wiley Periodicals LLC.) |
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| Contributed Indexing: | Keywords: atrial fibrillation; first‐pass isolation; high‐frequency jet ventilation; high‐frequency low tidal volume; pulmonary vein isolation; radiofrequency ablation |
| Entry Date(s): | Date Created: 20260630 Date Completed: 20260915 Latest Revision: 20260917 |
| Update Code: | 20260917 |
| PubMed Central ID: | PMC13576561 |
| DOI: | 10.1111/jce.70422 |
| PMID: | 42378402 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1540-8167 |
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| DOI: | 10.1111/jce.70422 |