Academic Journal
Respiration-Related Catheter Displacement and Physiological Tolerance of High-Frequency Very Low Tidal Volume Ventilation With Peak Pressure Limitation During Atrial Fibrillation Ablation: A Prospective 1-Way Crossover Pilot Study.
| Τίτλος: | Respiration-Related Catheter Displacement and Physiological Tolerance of High-Frequency Very Low Tidal Volume Ventilation With Peak Pressure Limitation During Atrial Fibrillation Ablation: A Prospective 1-Way Crossover Pilot Study. |
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| Συγγραφείς: | Ramírez-Paesano CR; Centro Médico Teknon, Quironsalud, Servei Central d'Anestesiología (Anestalia), Barcelona, Spain. Electronic address: cramirez@anestalia.com., Colina-Vargas YA; Centro Médico Teknon, Quironsalud, Servei Central d'Anestesiología (Anestalia), Barcelona, Spain., Teresi L; ICOR, Centro Médico Teknon, Quironsalud, Barcelona, Spain., Penela D; Department of Biomedical Sciences, Humanitas University, Milan, Italy., Falasconi G; ICOR, Centro Médico Teknon, Quironsalud, Barcelona, Spain., Amata F; ICOR, Centro Médico Teknon, Quironsalud, Barcelona, Spain., Tresandi D; Centro Médico Teknon, Quironsalud, Servei Central d'Anestesiología (Anestalia), Barcelona, Spain., Cersosimo A; ICOR, Centro Médico Teknon, Quironsalud, Barcelona, Spain., Olive JR; Centro Médico Teknon, Quironsalud, Servei Central d'Anestesiología (Anestalia), Barcelona, Spain., Soto-Iglesias D; ICOR, Centro Médico Teknon, Quironsalud, Barcelona, Spain., Marti-Almor J; ICOR, Centro Médico Teknon, Quironsalud, Barcelona, Spain., Berruezo A; ICOR, Centro Médico Teknon, Quironsalud, Barcelona, Spain. |
| Πηγή: | Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2026 Nov; Vol. 40 (11), pp. 3540-3552. Date of Electronic Publication: 2026 Jun 24. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: W.B. Saunders Country of Publication: United States NLM ID: 9110208 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8422 (Electronic) Linking ISSN: 10530770 NLM ISO Abbreviation: J Cardiothorac Vasc Anesth Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : W.B. Saunders, c1991- |
| Ιατρικοί όροι (MeSH): | Atrial Fibrillation*/surgery , Atrial Fibrillation*/physiopathology , Catheter Ablation*/methods , Catheter Ablation*/adverse effects , Tidal Volume*/physiology , High-Frequency Ventilation*/methods, Humans ; Cross-Over Studies ; Pilot Projects ; Prospective Studies ; Male ; Female ; Middle Aged ; Aged |
| Περίληψη: | Objective: To evaluate whether high-frequency, very low tidal volume ventilation with controlled peak inspiratory pressure limitation (HFvLTV-cPP) is associated with reduced respiration-related catheter displacement during atrial fibrillation (AF) ablation, while maintaining short-term physiological tolerance. Design: Prospective, single-center, fixed-sequence within-patient crossover pilot study. Setting: Tertiary electrophysiology center. Participants: Fifty-two consecutive eligible adult patients undergoing radiofrequency catheter ablation for AF under general anesthesia. Intervention: Standard ventilation followed by HFvLTV-cPP (50 breaths·min⁻¹, inspiratory-to-expiratory ratio 1:1, tidal volume titrated to minimize catheter displacement, peak inspiratory pressure ≤20 cmH Measurements and Main Results: HFvLTV-cPP was associated with a marked reduction in catheter displacement (6.22 ± 2.18 mm v 1.23 ± 0.69 mm; -4.99 mm, p < 0.001), corresponding to ∼80% reduction. Contact force was similar. Partial pressure of carbon dioxide increased from 38.0 ± 4.9 to 49.9 ± 7.2 mmHg, with values >60 mmHg in 9.6% of patients. Oxygenation remained preserved. Plateau pressures were not increased, and driving pressure was lower. Mean arterial pressure decreased after induction but not after HFvLTV-cPP, with modest vasopressor use. No procedural complications occurred. Early recovery was rapid, without early respiratory or neurologic complications. Conclusions: HFvLTV-cPP was associated with marked motion reduction and short-term physiological tolerance in a selected cohort. These findings represent a mechanistic signal and do not establish clinical benefit or safety. Randomized studies are required. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: anesthesia; atrial fibrillation; catheter ablation; catheter stability; high-frequency, very low tidal ventilation; hypercapnia; mechanical ventilation; peak pressure limitation |
| Entry Date(s): | Date Created: 20260716 Date Completed: 20261013 Latest Revision: 20261013 |
| Update Code: | 20261014 |
| DOI: | 10.1053/j.jvca.2026.06.032 |
| PMID: | 42463379 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1532-8422 |
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| DOI: | 10.1053/j.jvca.2026.06.032 |