Aims: An increasing number of transseptal punctures (TSPs) are performed worldwide for atrial ablations. Transseptal punctures can be complex and can be associated with potentially life threatening complications. The purpose of the study was to evaluate the safety and efficacy of a novel transseptal guidewire (TSGW) designed to facilitate TSPs.
Methods And Results: Transseptal punctures were performed using a SafeSept TSGW passed through a standard TSP apparatus. Transseptal punctures were performed by standard technique with additional use of a TSGW allowing probing of the interatrial septum without needle exposure and penetration of the fossa into the left atrium (LA). Transseptal puncture using the TSGW was performed in 210 patients. Left atrial access was achieved successfully in 205 of 210 patients (97.6%) and in 96.3% of patients undergoing repeat TSP. Left atrial access was achieved with the first pass in 81.2% (mean 1.4 ± 0.9 passes, range 1-6) using the TSGW. No serious complications were attributable to the use of the TSGW, even in cases of failed TSP.
Conclusions: The TSGW is associated with a high success rate for TSP and may be a useful alternative to transoesophageal or intracardiac echocardiogram-guided TSP.
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http://dx.doi.org/10.1093/europace/eur155 | DOI Listing |
JACC Clin Electrophysiol
January 2025
Section of Cardiac Pacing and Electrophysiology, Division of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA.
Background: In patients with mechanical aortic and mitral valves requiring catheter ablation of ventricular tachycardia (VT), a technique for access from the right atrium (RA) to the left ventricle (LV) via puncture of the inferoseptal process of the LV was previously described in a single-center series.
Objectives: This study sought to report the multicenter experience of VT ablation using this novel LV access approach.
Methods: We assembled a multicenter registry of patients with double mechanical valves who underwent VT ablation with RA-to-LV access.
Acta Cardiol
January 2025
Department of Cardiology, CHU HELORA Jolimont Hospital, La Louvière, Belgium.
This case report discusses the management of a 75-year-old man who developed an unusual type of atypical atrial flutter following a previous pulmonary vein isolation for paroxysmal atrial fibrillation. Despite a second attempt to re-isolate the pulmonary veins and performing cavotricuspid isthmus ablation (which was suspected to be part of the arrythmia circuit), the flutter continued and was converted to sinus rhythm through electrical cardioversion. A few weeks later, the patient's atrial tachycardia relapsed.
View Article and Find Full Text PDFJ Clin Med
December 2024
Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, 40225 Düsseldorf, Germany.
: The safety and efficacy of electrophysiological (EP) procedures using ultrasound (US) guidance are being increasingly studied. We investigated if a systematic workflow with ultrasound guidance (the US4ABL), comprising four steps (transesophageal echocardiography (TEE) for left atrial thrombus exclusion, US of the groin vessels to guide femoral access, TEE-aided transseptal puncture, and transthoracic echocardiography (TTE) for exclusion of pericardial tamponade after the procedure), reduces the number of complications and fluoroscopy duration and dose. : A total of 212 consecutive patients underwent left-sided ablations using the US4ABL workflow and were compared to a group of 299 patients who underwent the same type of ablations using post-procedural TTE to exclude tamponade (standard group: venous and/or arterial access by palpation and fluoroscopy, and pressure guided transseptal puncture).
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Department of Cardiovascular Medicine, Sendai Kousei Hospital, 1-20 Tsutsumidori-amamiya, Aoba Ward, Sendai, Miyagi 9810914, Japan.
Sci Rep
December 2024
Department of Cardiology, West China Hospital of Sichuan University, 37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan, China.
Intracardiac echocardiography (ICE) has been used to guide radio-frequency catheter ablation (RFCA) for better catheter navigation and less radiation exposure in treating atrial fibrillation (AF). This retrospective cohort study enrolled 227 AF patients undergoing ICE- or traditional fluoroscopy (TF)-guided RFCA for AF in a tertiary hospital. ICE was used more often in patients with atrial tachycardia [odds ratio (OR) 3.
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