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VersaCross radiofrequency system reduces time to left atrial access versus conventional mechanical needle

Abstract

Background

Despite maturing experience, transseptal puncture (TSP) remains a challenging part of percutaneous left atrial appendage closure (LAAC) and has inherent risks and safety concerns in accessing the left atrium (LA). The VersaCross radiofrequency (RF) system (Baylis Medical), a new RF-tipped pigtail wire-based TSP system, may facilitate LA access by serving as an exchange support wire once access is achieved.

Methods

We retrospectively compared TSP safety and procedural efficiency in 10 consecutive LAAC cases using the VersaCross RF system to 10 cases using the conventional BRK1-XS mechanical needle (Abbott Vascular). The safety and time from femoral access to delivery of the device sheath were compared to the conventional workflow using BRK1-XS/SL1.

Results

We included consecutive 20 cases between July 2019 and November 2019 (12 with WATCHMAN (Boston Scientific, Natick, MA) and 8 with Amulet (St. Jude Medical, St Paul, MN)). Baseline patient characteristics and procedural details were similar in both groups (VersaCross RF system vs. conventional BRK1-XS mechanical needle). All cases were completed successfully with no procedural or in-hospital complications. VersaCross reduced time from femoral access to TSP [4.1 ± 2.5 min vs. 8.4 ± 4.0 min (p = 0.009)] and time from femoral access to delivery sheath access into LA [6.7 ± 2.4 min vs. 13.4 ± 5.4 min (p = 0.002)] compared to BRK1-XS.

Conclusions

Combining a starter wire, transseptal needle and exchange guidewire in the VersaCross RF system enabled faster LA access, which potentially leads to efficient workflow. Further investigation with larger sample size is warranted to corroborate our findings.

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Authors

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Correspondence to Jacqueline Saw.

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Disclosures

Dr. Saw has received unrestricted research grant supports (from the Canadian Institutes of Health Research, Heart & Stroke Foundation of Canada, National Institutes of Health, AstraZeneca, Abbott Vascular, St Jude Medical, Boston Scientific, and Servier), salary support (Michael Smith Foundation for Health Research), speaker honoraria (AstraZeneca, Abbott Vascular, Boston Scientific, Bayer), consultancy and advisory board honoraria (AstraZeneca, Boston Scientific, Abbott Vascular, Gore, Baylis and Abiomed), and proctorship honoraria (Abbott Vascular and Boston Scientific).

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Inohara, T., Gilhofer, T., Luong, C. et al. VersaCross radiofrequency system reduces time to left atrial access versus conventional mechanical needle. J Interv Card Electrophysiol (2021). https://doi.org/10.1007/s10840-020-00931-7

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Keywords

  • VersaCross
  • Transseptal puncture
  • Atrial fibrillation
  • Left atrial appendage closure