A practical guide for building a highway between atria during transseptal puncture without radiation

Area of Science:

• Electrophysiology
• Cardiac Ablation
• Medical Imaging

Background:

• Fluoroscopy is traditionally used for guiding catheter ablation procedures.
• Minimizing radiation exposure is a key goal in interventional cardiology.

Purpose of the Study:

• To evaluate the feasibility and safety of transseptal catheter crossing without fluoroscopy.
• To assess the efficacy of the Carto3 system for real-time catheter navigation.

Main Methods:

• Forty patients with persistent atrial fibrillation underwent catheter ablation using a "2C3L" approach.
• Patients were randomized to either a fluoroscopy-guided (trackless) or Carto3-guided (track) transseptal crossing.
• The Carto3 system generated a 3D image of the track for navigation.

Main Results:

• Both groups achieved 100% success rates for transseptal crossing.
• The Carto3-guided group completed septum crossing significantly faster (4±3 s vs. 20±10 s).
• Zero fluoroscopy was used in the Carto3-guided group for septum crossing.

Conclusions:

• Visualizing the transseptal track with the Carto3 system allows safe and rapid catheter navigation.
• This zero-fluoroscopy technique enhances patient safety by eliminating radiation exposure.
• The Carto3 system provides a reliable alternative to fluoroscopy for transseptal crossing.