Improved left atrial appendage closure procedural efficiency using radiofrequency transseptal wire system.

Area of Science:

• Cardiovascular Interventions
• Electrophysiology
• Medical Device Technology

Background:

• Radiofrequency (RF) needles enhance transseptal puncture safety and efficiency over mechanical needles.
• Left atrial appendage closure (LAAC) is a key procedure for stroke prevention in atrial fibrillation.

Purpose of the Study:

• To evaluate the VersaCross RF transseptal wire system for improving procedural efficiency in LAAC.
• To compare the RF wire-based workflow against the standard RF needle-based workflow for LAAC.

Main Methods:

• Retrospective analysis of 81 LAAC procedures using WATCHMAN FLX.
• Comparison between a standard RF needle-based workflow (25 cases) and an RF wire-based workflow (56 cases).
• Primary endpoint: time to WATCHMAN device release; Secondary endpoints: transseptal puncture time, success rate, fluoroscopy, and complications.

Main Results:

• LAAC success was 100% in both groups, with similar complication rates.
• Transseptal puncture time was significantly faster with the RF wire-based workflow (6.5 ± 2.3 min vs. 7.8 ± 2.3 min, p=0.02).
• Overall procedure time to device release was reduced by 4.5 min (24.6 ± 5.6 min vs. 29.1 ± 9.6 min, p=0.01).
• Fluoroscopy time decreased by 21% and radiation dose by 67% with the RF wire-based workflow (p<0.05).

Conclusions:

• The RF wire-based workflow significantly improves LAAC procedural efficiency.
• This method reduces procedure time, fluoroscopy exposure, and device delivery complexities.
• The VersaCross RF transseptal wire system offers a streamlined and safer approach to LAAC.