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Updated: Oct 8, 2025

Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter
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Reversible Mechanical Atrioventricular Block Caused By A Steerable Introducer Sheath During Transseptal

Gregory P Siroky1,2, Devendra Bisht1,2, Hieu Huynh1

  • 1Mount Sinai Morningside, Icahn School of Medicine at Mount Sinai, New York, NY 10025.

Journal of Atrial Fibrillation
|December 24, 2021
PubMed

A 62-year-old woman presents for pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation. During transseptal catheterization (TSC) the patient sustained mechanical injury to the atrioventricular node (AVN) with consequent complete heart block (CHB). Injury to the AVN and CHB recovered after approximately forty minutes. The patient subsequently underwent a successful PVI with the remainder of the hospital stay uneventful. We present a case of reversible injury to the AVN caused by a steerable introducer sheath during TSC and discuss the mechanisms of injury as well as potential measures to avoid such a complication in the future.

Keywords:
Mechanical Atriventricular BlockSteerable SheathTransseptal Puncture

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