Initial Experience Using the Radiofrequency Needle Visualization on the Electroanatomical Mapping System for Transseptal Puncture
Introduction. Transseptal puncture (TSP) is a routine access route in patients with left-sided ablation substrates and is performed safely on fluoroscopy (+/− echocardiographic guidance). We report on our experience using a radiofrequency (RF) needle in an unselected group of patients to demonstrate...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/5420909 |
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| author | Silvia Guarguagli Ilaria Cazzoli Aleksander Kempny Michael A. Gatzoulis Sabine Ernst |
| author_facet | Silvia Guarguagli Ilaria Cazzoli Aleksander Kempny Michael A. Gatzoulis Sabine Ernst |
| author_sort | Silvia Guarguagli |
| collection | DOAJ |
| description | Introduction. Transseptal puncture (TSP) is a routine access route in patients with left-sided ablation substrates and is performed safely on fluoroscopy (+/− echocardiographic guidance). We report on our experience using a radiofrequency (RF) needle in an unselected group of patients to demonstrate safety and usefulness of direct tip visualization on the 3D electroanatomical mapping (EAM) system with specific emphasis on total radiation exposure. Methods and Results. We retrospectively reviewed 42 consecutive left-sided ablation procedures with TSP performed using an RF needle guided by fluoroscopy and/or EAM visualization by a single operator. The procedures included atrial fibrillation (n = 33), atrial tachycardia (n = 8), and ventricular tachycardia (n = 1) ablations. Fourteen of 41 patients had congenital heart disease, including 9 patients with previous septal closure. Twenty-two patients had at least one previous TSP. All TSPs were performed successfully and without complications. The overall median fluoroscopy time amounted to 3.2 min and median exposure of 199.5 µGy∗m2. In a subgroup of patients (n = 27), the RF needle was visualized on the EAM system: median radiation time was 0.88 (interquartile range: 0–3.4) min and median exposure 33.5 [0–324.8] µGy∗m2. Conclusions. TSP using an RF needle is an effective technique, also in congenital patients with artificial patch material and in normal patients with multiple previous TSPs. Moreover, the RF needle tip visualization on EAM allows a low (or even zero) fluoroscopy approach. |
| format | Article |
| id | doaj-art-fd2c99ca2dc247bd8633ef022bf57897 |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
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| series | Cardiology Research and Practice |
| spelling | doaj-art-fd2c99ca2dc247bd8633ef022bf578972025-02-03T06:46:56ZengWileyCardiology Research and Practice2090-80162090-05972020-01-01202010.1155/2020/54209095420909Initial Experience Using the Radiofrequency Needle Visualization on the Electroanatomical Mapping System for Transseptal PunctureSilvia Guarguagli0Ilaria Cazzoli1Aleksander Kempny2Michael A. Gatzoulis3Sabine Ernst4Department of Cardiology, Royal Brompton and Harefield Hospital and Imperial College London, London, UKDepartment of Cardiology, Royal Brompton and Harefield Hospital and Imperial College London, London, UKDepartment of Cardiology, Royal Brompton and Harefield Hospital and Imperial College London, London, UKDepartment of Cardiology, Royal Brompton and Harefield Hospital and Imperial College London, London, UKDepartment of Cardiology, Royal Brompton and Harefield Hospital and Imperial College London, London, UKIntroduction. Transseptal puncture (TSP) is a routine access route in patients with left-sided ablation substrates and is performed safely on fluoroscopy (+/− echocardiographic guidance). We report on our experience using a radiofrequency (RF) needle in an unselected group of patients to demonstrate safety and usefulness of direct tip visualization on the 3D electroanatomical mapping (EAM) system with specific emphasis on total radiation exposure. Methods and Results. We retrospectively reviewed 42 consecutive left-sided ablation procedures with TSP performed using an RF needle guided by fluoroscopy and/or EAM visualization by a single operator. The procedures included atrial fibrillation (n = 33), atrial tachycardia (n = 8), and ventricular tachycardia (n = 1) ablations. Fourteen of 41 patients had congenital heart disease, including 9 patients with previous septal closure. Twenty-two patients had at least one previous TSP. All TSPs were performed successfully and without complications. The overall median fluoroscopy time amounted to 3.2 min and median exposure of 199.5 µGy∗m2. In a subgroup of patients (n = 27), the RF needle was visualized on the EAM system: median radiation time was 0.88 (interquartile range: 0–3.4) min and median exposure 33.5 [0–324.8] µGy∗m2. Conclusions. TSP using an RF needle is an effective technique, also in congenital patients with artificial patch material and in normal patients with multiple previous TSPs. Moreover, the RF needle tip visualization on EAM allows a low (or even zero) fluoroscopy approach.http://dx.doi.org/10.1155/2020/5420909 |
| spellingShingle | Silvia Guarguagli Ilaria Cazzoli Aleksander Kempny Michael A. Gatzoulis Sabine Ernst Initial Experience Using the Radiofrequency Needle Visualization on the Electroanatomical Mapping System for Transseptal Puncture Cardiology Research and Practice |
| title | Initial Experience Using the Radiofrequency Needle Visualization on the Electroanatomical Mapping System for Transseptal Puncture |
| title_full | Initial Experience Using the Radiofrequency Needle Visualization on the Electroanatomical Mapping System for Transseptal Puncture |
| title_fullStr | Initial Experience Using the Radiofrequency Needle Visualization on the Electroanatomical Mapping System for Transseptal Puncture |
| title_full_unstemmed | Initial Experience Using the Radiofrequency Needle Visualization on the Electroanatomical Mapping System for Transseptal Puncture |
| title_short | Initial Experience Using the Radiofrequency Needle Visualization on the Electroanatomical Mapping System for Transseptal Puncture |
| title_sort | initial experience using the radiofrequency needle visualization on the electroanatomical mapping system for transseptal puncture |
| url | http://dx.doi.org/10.1155/2020/5420909 |
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