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Intracardiac shunts resulting from transseptal catheterization for ablation of accessory pathways in otherwise normal

D J Kessler1, M J Pirwitz, R P Horton

  • 1University of Texas Southwestern Medical Center, Dallas 75235, USA.

The American Journal of Cardiology
|August 26, 1998
PubMed

Insights

Transseptal catheterization for accessory pathway ablation can cause left-to-right shunting. Hydrogen appearance time detected new shunts in 50% of patients post-procedure, indicating a potential complication.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Transseptal catheterization is a common procedure for treating cardiac arrhythmias.
  • Left-sided accessory pathways require transseptal access for ablation.
  • Potential complications, such as cardiac shunting, need careful monitoring.

Purpose of the Study:

  • To evaluate the incidence of left-to-right shunting after transseptal catheterization.
  • To assess the utility of hydrogen appearance time in detecting post-procedural shunts.

Main Methods:

  • A series of 14 patients undergoing transseptal catheterization for accessory pathway ablation were studied.
  • Hydrogen appearance time was measured to detect shunting.
  • Shunt detection was performed after catheter removal.

Main Results:

  • Six out of 12 patients (50%) who initially had no evidence of shunting developed shunts post-procedure.
  • The hydrogen appearance time method successfully identified left-to-right shunts.

Conclusions:

  • Transseptal catheterization for accessory pathway ablation is associated with a significant incidence of iatrogenic left-to-right shunting.
  • Hydrogen appearance time is a sensitive method for detecting these post-procedural shunts.

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