Controlled ventilation enhances catheter stability during radiofrequency ablation

Area of Science:

• Cardiology
• Medical Engineering
• Anesthesiology

Background:

• Respiration causes amplitude variations in atrial and ventricular depolarization waves on intracardiac electrograms.
• These variations can complicate radiofrequency ablation procedures for cardiac arrhythmias.

Purpose of the Study:

• To evaluate if controlled ventilation reduces ablation attempts and increases success rates in pediatric patients undergoing radiofrequency ablation under general anesthesia.
• To determine the optimal ventilation phase for stable electrogram recording during ablation.

Main Methods:

• Thirty-eight pediatric patients were divided into controlled and non-controlled ventilation groups.
• In the controlled group, electrograms were recorded during sustained inspiration, expiration, and cyclic ventilation.
• Ablation was performed during the ventilation phase with minimal atrial and ventricular amplitude variability.

Main Results:

• Controlled ventilation led to fewer ablation attempts (3 +/- 2) compared to cyclic ventilation (8 +/- 8).
• Ablation during sustained inspiration or expiration in the controlled group showed significantly less amplitude variability than cyclic ventilation.
• All patients in both groups achieved successful ablation.

Conclusions:

• Controlled ventilation effectively reduces the number of ablation attempts during radiofrequency ablation in children.
• This method enhances procedural efficiency and electrogram stability, facilitating successful cardiac arrhythmia ablation.