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Original Article
Published online: 2020-01-21
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Transseptal puncture without fluoroscopy using a radiofrequency needle: A case series

Guram Imnadze, Tarek Ajaj, Hendrik Bante, Christian Sohns, Philipp Sommer
DOI: 10.5603/CJ.a2020.0008
·
Pubmed: 32037502

open access

Ahead of print
Original articles
Published online: 2020-01-21

Abstract

Background: The non-fluoroscopy approach with the use of a three-dimensional (3D) navigation system is increasingly recognized as a future technology in the treatment of arrhythmias. However, there are a limited number of articles published concerning transseptal puncture without the use of fluoroscopy.

Methods: Presented in this paper is  the first series of patients (n = 10) that have undergone transseptal puncture without the use of fluoroscopy under transesophageal echocardiography control using a radiofrequency transseptal needle and a 3D navigation system.

Results: All patients were treated without complications. In six patients, re-pulmonary vein isolation was performed. In 5 cases, linear ablation of the left atrium for treatment of left atrial macro re-entry tachycardia was provided. In 2 patients, focal atrial tachycardia was treated, 1 patient underwent cavo tricuspidal isthmus (CTI) ablation and one patient, re-CTI ablation. The ablation of complex fragmented atrial electrograms was done in 2 patients. In 1 case, right atrial macro re-entry tachycardia was treated. 

Conclusions: Transseptal puncture without using fluoroscopy is safe and effective when using a radiofrequency needle, a 3D navigation system and transesophageal echocardiography.

Abstract

Background: The non-fluoroscopy approach with the use of a three-dimensional (3D) navigation system is increasingly recognized as a future technology in the treatment of arrhythmias. However, there are a limited number of articles published concerning transseptal puncture without the use of fluoroscopy.

Methods: Presented in this paper is  the first series of patients (n = 10) that have undergone transseptal puncture without the use of fluoroscopy under transesophageal echocardiography control using a radiofrequency transseptal needle and a 3D navigation system.

Results: All patients were treated without complications. In six patients, re-pulmonary vein isolation was performed. In 5 cases, linear ablation of the left atrium for treatment of left atrial macro re-entry tachycardia was provided. In 2 patients, focal atrial tachycardia was treated, 1 patient underwent cavo tricuspidal isthmus (CTI) ablation and one patient, re-CTI ablation. The ablation of complex fragmented atrial electrograms was done in 2 patients. In 1 case, right atrial macro re-entry tachycardia was treated. 

Conclusions: Transseptal puncture without using fluoroscopy is safe and effective when using a radiofrequency needle, a 3D navigation system and transesophageal echocardiography.

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Keywords

non-fluoroscopic approach, transseptal puncture, radiofrequency needle, three-dimensional mapping system

Supplementary Files (3)
Video 1. Anatomical map of right sided heart structure. the right (RAO) and left (LAO) anterior oblique projections. (see also the text and the figure 1)
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5MB
Video 2. 3D anatomical map of the Anatomical structures in RAO and LAO projections
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Video 3. TEE frames of the transseptal punction with the RF needle, in short (left) and bicaval (right) views
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14MB
About this article
Title

Transseptal puncture without fluoroscopy using a radiofrequency needle: A case series

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2020-01-21

DOI

10.5603/CJ.a2020.0008

Pubmed

32037502

Keywords

non-fluoroscopic approach
transseptal puncture
radiofrequency needle
three-dimensional mapping system

Authors

Guram Imnadze
Tarek Ajaj
Hendrik Bante
Christian Sohns
Philipp Sommer

References (16)
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