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Related Experiment Video

Updated: Feb 9, 2026

Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter

Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter

Published on: June 15, 2015

Fluoroscopy-free Atrial Transseptal Puncture.

Mark D McCauley¹, Nisarg Patel², Scott J Greenberg³

¹Department of Medicine, Section of Cardiology, The University of Illinois at Chicago and the Jesse Brown VA Medical Center, Chicago, Illinois, US.

European Journal of Arrhythmia & Electrophysiology

|June 5, 2018

Summary

Zero-fluoroscopy transseptal puncture (ZFTSP) using electroanatomical mapping and intracardiac echo is a safe and effective alternative to traditional methods. This technique significantly reduces radiation exposure for patients and physicians during atrial fibrillation ablation.

Keywords:

Atrial fibrillation electro-anatomical mapping intracardiac echocardiography transseptal puncture zero-fluoroscopy

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Area of Science:

Cardiology
Medical Imaging
Electrophysiology

Background:

Traditional transseptal puncture (TSP) relies on fluoroscopy, posing risks of radiation exposure to patients and physicians.
Atrial fibrillation (AF) ablation procedures often require TSP for accessing the left atrium.

Purpose of the Study:

To evaluate the feasibility and effectiveness of a zero-fluoroscopy transseptal puncture (ZFTSP) technique.
To compare the ZFTSP technique utilizing electroanatomical mapping (EAM) and intracardiac echo (ICE) with established methods for paroxysmal AF ablation.

Main Methods:

A feasibility study involving seven patients undergoing ZFTSP using EAM and ICE.
Inclusion of an ICE catheter for visualization and an EAM catheter for mapping the fossa ovalis.
Comparison of procedure times, fluoroscopy times, and AF recurrence rates with a control group of eight patients who underwent traditional TSP.

Main Results:

No significant differences in patient demographics or AF duration between ZFTSP and control groups.
ZFTSP demonstrated a significantly shorter procedure time (183.9 min vs. 293.1 min) and fluoroscopy time (17.5 min vs. 73.4 min).
AF recurrence was lower in the ZFTSP group (14%) compared to the control group (25%).

Conclusions:

ZFTSP utilizing ICE and EAM is a safe, effective, and time-efficient method for transseptal puncture.
This technique offers a significant reduction in radiation exposure for both patients and physicians.
ZFTSP presents a promising alternative for AF ablation procedures, improving safety and efficiency.