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PO-03-016 IMPACT OF JET VENTILATION, HIGH FREQUENCY LOW TIDAL VOLUME VERSUS STANDARD VENTILATION TO REDUCE ATRIAL FIBRILLATION RECURRENCES AFTER ABLATION: RESULTS FROM THE REAL-AF REGISTRY
Abstract   Peer reviewed

PO-03-016 IMPACT OF JET VENTILATION, HIGH FREQUENCY LOW TIDAL VOLUME VERSUS STANDARD VENTILATION TO REDUCE ATRIAL FIBRILLATION RECURRENCES AFTER ABLATION: RESULTS FROM THE REAL-AF REGISTRY

Olivia Moore, Michelle Samuel, Summer E. Ballou, Dallin Kelly, Caitlin Phalunas, Prateeth Pati, Brian Sanchez, Alan Li, Alexandru Costea, Daniela Hincapie Tabares, …
Heart rhythm, Vol.23(4 Supplement), pp.S504-S505
04/2026
DOI: 10.1016/j.hrthm.2026.03.739

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Abstract

Background High frequency Jet (JET) and high-frequency, low-tidal-volume (HFLTV) are both forms of ventilation used during atrial fibrillation (AF) ablation to stabilize catheter movement and improve lesion delivery. In contrast, standard ventilation (SV) creates notable respiratory movement, negatively affecting catheter stability and lesion delivery. Current evidence suggests similar acute procedural success between ventilation modalities, however AF recurrences over the long-term have seldom been investigated. Objective To compare the 1-year incidence of AF recurrences and complications between AF ablation patients who underwent JET, HFLTV versus standard ventilation. Methods We analyzed data from the REAL-AF multicenter AF ablation registry for patients who underwent index radiofrequency (RF) ablation for persistent or paroxysmal AF between 2020-2024 with documented ventilation method. The outcome of AF recurrence was captured via standard of care AF monitoring. Multivariable Cox models clustered by physician and adjusted for demographic and procedural characteristics were performed to compare the incidence of AF recurrences between ventilation modes. Results Of the 12750 patients, HFLTV was the predominant ventilation mode (54%), followed by standard ventilation (38%) and JET (8%). Adjusted Cox models demonstrated a statistically significant decrease in AF recurrence at the 12-month period following RF ablation with HFLTV (HR 0.85, 95% CI 0.73-0.99), while JET showed no significant reduction in AF recurrence (HR 1.15, 95% CI 0.81-1.64), all compared to SV. The incidence of pericarditis was lowest in HFLTV patients (0.3%; p=0.046). No differences were detected for other complications. Conclusion In the largest study comparing outcomes between patients undergoing AF ablation using HFLTV, JET, and SV, the incidence of 1-year post-ablation AF recurrences were lowest among the group who had index AF ablation with HFLTV. Complications rates warrant further investigation.

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