Recovery and safety with prolonged high-frequency jet ventilation for catheter ablation of atrial fibrillation: A hospital registry study from a New England healthcare network

Munoz-Acuna, R; Tartler, TM; Azizi, BA; Suleiman, A; Ahrens, E; Wachtendorf, LJ; Linhardt, FC; Chen, G; Tung, P; Waks, JW; Schaefer, MS; Sehgal, S

doi:10.1016/j.jclinane.2023.111324

Respiratory failure & ventilation

Recovery and safety with prolonged high-frequency jet ventilation for catheter ablation of atrial fibrillation: A hospital registry study from a New England healthcare network

J Clin AnesthPublished 23 Nov 2023Retrospective hospital registry study

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Authors' conclusion

After confounder adjustment, HFJV for catheter ablation procedures for treatment of atrial fibrillation was associated with a longer length of stay in the PACU.

Study context

Population: Adults ≥18 years undergoing catheter ablation for AF, tertiary academic hospital in New England, January 2013–June 2020
Participants: 1,822 adults

Exposure: High-frequency jet ventilation (HFJV) vs conventional mechanical ventilation
HFJVn = 1,157
Outcome: PACU LOS

Methodological detailssingle-centre, multivariable-adjusted, HFJV median (IQR) duration 307 (253-360) minutes

Single-centre
Multivariable-adjusted
HFJV median (IQR) duration 307 (253-360) minutes

Main finding

As reported in the abstract

Adjusted absolute difference

37.7 min

95% CI 9.7–65.8

P = 0.008

By group

Conventional ventilation244median · IQR 172–370 · minutes

HFJV226median · IQR 163–361 · minutes

HFJV vs Conventional ventilation

adjusted absolute difference 37.7 min (95% CI 9.7–65.8); P = 0.008

Observational data: associations, not effects.

Further findings

Outcome	P value
Intra-procedural hypoxemia (SpO2 <90%) and postprocedural respiratory complicationsHFJV vs Conventional ventilation · hypoxemia	P = 0.51
Intra-procedural hypoxemia (SpO2 <90%) and postprocedural respiratory complicationsHFJV vs Conventional ventilation · PRC	P = 0.97

Intra-procedural hypoxemia (SpO2 <90%) and postprocedural respiratory complications

No association between HFJV and intra-procedural hypoxemia or PRC

Safety

Outcome	← Lower odds with HFJV ←→ Higher odds with HFJV →	aOR (95% CI)	P value
Intra-procedural hypocarbia	0.050.21520	5.90 (2.63–13.23)	P < 0.001
Intra-procedural hypotension	0.050.21520	1.88 (1.31–2.72)	P = 0.001
	0.050.21520Adjusted odds ratio (log scale)

Original publication

Recovery and safety with prolonged high-frequency jet ventilation for catheter ablation of atrial fibrillation: A hospital registry study from a New England healthcare network. J Clin Anesth. Published 23 November 2023. doi:10.1016/j.jclinane.2023.111324

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