Transseptal puncture without fluoroscopy using a radiofrequency needle: A case series
Guram Imnadze1,2, Tarek Ajaj3, Hendrik Bante3
1Arrhythmia Department, Klinikum Osnabrueck, Germany. imnadze@web.de.
Cardiology Journal
|February 11, 2020
Summary
Transseptal puncture without fluoroscopy is safe and effective for treating arrhythmias. This study demonstrates a novel approach using a 3D navigation system and transesophageal echocardiography, paving the way for reduced radiation exposure.
Area of Science:
- Electrophysiology
- Cardiovascular Interventions
- Medical Imaging
Background:
- Fluoroscopy-free approaches are emerging for arrhythmia treatment.
- Limited data exists on transseptal puncture without fluoroscopy.
- Three-dimensional (3D) navigation systems offer advanced visualization.
Purpose of the Study:
- To evaluate the safety and efficacy of transseptal puncture without fluoroscopy.
- To present the initial patient series using this novel technique.
- To explore the application of 3D navigation and transesophageal echocardiography in transseptal procedures.
Main Methods:
- Transseptal puncture performed in 10 patients without fluoroscopy.
- Utilized transesophageal echocardiography for procedural guidance.
- Employed a radiofrequency transseptal needle and a 3D navigation system.
Main Results:
- All procedures were completed without complications.
- Successful treatment of various arrhythmias including re-pulmonary vein isolation, left atrial macro re-entry tachycardia, focal atrial tachycardia, and cavo tricuspidal isthmus ablation.
- Demonstrated feasibility of ablating complex fragmented atrial electrograms.
Conclusions:
- Transseptal puncture without fluoroscopy is a safe and effective alternative.
- The combination of radiofrequency needle, 3D navigation, and transesophageal echocardiography facilitates fluoroscopy-free procedures.
- This approach holds promise for reducing radiation exposure in arrhythmia management.
