Initial Experience Using the Radiofrequency Needle Visualization on the Electroanatomical Mapping System for...

Area of Science:

• Cardiovascular Interventions
• Electrophysiology
• Medical Imaging

Background:

• Transseptal puncture (TSP) is a standard approach for left-sided cardiac ablation.
• Current guidance relies on fluoroscopy and/or echocardiography.
• Radiofrequency (RF) needles offer potential for improved visualization.

Purpose of the Study:

• To evaluate the safety and utility of an RF needle for TSP.
• To assess the benefit of direct tip visualization on 3D electroanatomical mapping (EAM) systems.
• To determine the impact on total radiation exposure.

Main Methods:

• Retrospective review of 42 consecutive left-sided ablation procedures using an RF needle.
• Procedures guided by fluoroscopy and/or EAM by a single operator.
• Analysis of patient demographics, including congenital heart disease and prior TSPs.

Main Results:

• All 42 TSPs were successful and complication-free.
• Median fluoroscopy time was 3.2 minutes (199.5 µGy m²).
• In a subgroup (n=27) with EAM visualization, median radiation time was 0.88 minutes (33.5 µGy m²).

Conclusions:

• RF needle TSP is effective, even in patients with congenital heart disease or multiple prior punctures.
• Direct RF needle tip visualization on EAM enables a low or zero fluoroscopy approach.
• This technique enhances safety and reduces radiation exposure in transseptal procedures.