Abstract
Ablation for atrial fibrillation is now widespread and may involve the delivery of relatively high doses of ionizing radiation to both patients and operators. Until now, atrial septal puncture has mandated the use of either fluoroscopy or additional expensive imaging modalities for its safe deployment. We describe a novel technique using the EnSite NavX three-dimensional imaging system for visualization of the transseptal needle throughout the puncture—without the need for either fluoroscopy or additional imaging. This may be important in reducing the need for fluoroscopy for left atrial ablation procedures.
References
Oral, H., Chugh, A., Good, E., Sankaran, S., Reich, S. S., Igic, P., et al. (2006). A tailored approach to catheter ablation of paroxysmal atrial fibrillation. Circulation, 113, 1824–1831.
Ouyang, F., Ernst, S., Chun, J., Bansch, D., Li, Y., Schaumann, A., et al. (2005). Electrophysiological findings during ablation of persistent atrial fibrillation with electroanatomic mapping and double Lasso catheter technique. Circulation, 112, 3038–3048.
Rogers, D. P., Lambiase, P. D., Dhinoja, M., Lowe, M. D., & Chow, A. W. (2006). Right atrial angiography facilitates transseptal puncture for complex ablation in patients with unusual anatomy. Journal of Interventional Cardiac and Electrophysiology, 17, 29–34 Oct.
Ren, J. F., & Marchlinski, F. E. (2007). Utility of intracardiac echocardiography in left heart ablation for tachyarrhythmias. Echocardiography, 24(5), 533–540 May.
Roelke, M., Smith, A. J., & Palacios, I. F. (1994). The technique and safety of transseptal left heart catheterization: the Massachusetts General Hospital experience with 1279 procedures. Catheterization and Cardiovascular Diagnosis, 32, 332–339.
Drago, F., Silvette, M. S., Di Pino, A., Grutter, G., Bevilacqua, M., & Leibovich, S. (2002). Exclusion of fluoroscopy during ablation treatment of right accessory pathways in children. Journal of Cardiovascular Electrophysiology, 13, 778–782.
Verma, S., & Borganelli, M. (2006). Real-time, three-dimensional localization of a Brockenbrough needle during transseptal catheterization using a nonfluoroscopic mapping system. Journal of Invasive Cardiology, 18, 324–327 Medline, Jul.
Gonzalez, M. D., Otomo, K., Shah, N., Arruda, M. S., Beckmann, K. J., Lazzara, R., et al. (2001). Transseptal left heart catheterization for cardiac ablation procedures. Journal of Interventional Cardiac and Electrophysiology, 5, 89–95.
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Shepherd, E.J., Gall, S.A. & Furniss, S.S. Interatrial septal puncture without the use of fluoroscopy—reducing ionizing radiation in left atrial ablation procedures. J Interv Card Electrophysiol 22, 183–187 (2008). https://doi.org/10.1007/s10840-008-9263-9
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DOI: https://doi.org/10.1007/s10840-008-9263-9