open access

Vol 28, No 5 (2021)
Original Article
Submitted: 2019-07-10
Accepted: 2019-12-24
Published online: 2020-01-21
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Transseptal puncture without fluoroscopy using a radiofrequency needle: A case series

Guram Imnadze12, Tarek Ajaj1, Hendrik Bante1, Christian Sohns2, Philipp Sommer2
·
Pubmed: 32037502
·
Cardiol J 2021;28(5):655-662.
Affiliations
  1. Arrhythmia Department, Klinikum Osnabrueck, Germany
  2. Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany

open access

Vol 28, No 5 (2021)
Original articles — Interventional cardiology
Submitted: 2019-07-10
Accepted: 2019-12-24
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 6 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 1 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 6 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 1 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

Supp./Additional 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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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

Vol 28, No 5 (2021)

Article type

Original Article

Pages

655-662

Published online

2020-01-21

Page views

12158

Article views/downloads

1076

DOI

10.5603/CJ.a2020.0008

Pubmed

32037502

Bibliographic record

Cardiol J 2021;28(5):655-662.

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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