[An application of His bundle electrogram to locate fossa ovalis during percutaneous transseptal balloon...

A new technique to locate the point of atrial septal puncture, i.e. His bundle electrogram locating method (HBELM), was reported. By using this HBELM, the successful rate of atrial septal puncture was 100% in 21 cases of mitral stenosis during percutaneous transseptal balloon valvuloplasty and in 5 cases of them, the puncture needle got into left atrium smoothly through patent fossa ovalis at the position determined by HBELM without making puncture. As well known, the point of atrial septal puncture is fossa ovalis. According to the anatomy, His bundle is located at the same horizontal line as fossa ovalis. After HBE being recorded, a horizontal line is drawn from the point of His bundle catheter electrode. The authors suggest that the intersect of this line with right border of thoracic vertebra should be the point of atrial septal puncture. The above study showed that HBELM for atrial septal puncture is a correct and easy method and may be better than other methods used before.