Safety and Effectiveness of a Novel Fluoroless Transseptal Puncture Technique for Lead-free Catheter Ablation: A Case Series
| Autor: | Lane Wilson, Michael Morin, Tariq Salam, Sara Bohannan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Tachycardia
medicine.medical_specialty medicine.medical_treatment transseptal puncture Inferior vena cava filter Catheter ablation Ventricular tachycardia fluoroless electroanatomic mapping Physiology (medical) catheter ablation medicine Fluoroscopy cardiovascular diseases Original Research medicine.diagnostic_test business.industry Atrial fibrillation medicine.disease Ablation Surgery cardiovascular system medicine.symptom Cardiology and Cardiovascular Medicine business Atrial flutter |
| Zdroj: | The Journal of Innovations in Cardiac Rhythm Management |
| ISSN: | 2156-3993 2156-3977 |
| Popis: | Increasing awareness of the health risks associated with the exposure of patients and staff in the catheterization laboratory to radiation has encouraged the pursuit of efforts to reduce the use of fluoroscopy during catheter ablation procedures. Although nonfluoroscopic guidance of ablation catheters has been previously described, transseptal access is still perceived as the last remaining barrier to completely fluoroless ablations. This study examined the safety and effectiveness of transseptal puncture and radiofrequency (RF) catheter ablation using a completely fluoroless approach. Three hundred eighty-two consecutive cases that had undergone completely nonfluoroscopic RF catheter ablation were evaluated. Ablation procedures were performed for atrial fibrillation, atrial flutter, atrioventricular reentry tachycardia, and pulmonary vein complex/ventricular tachycardia. Transseptal puncture and RF ablation were conducted under three-dimensional electroanatomic mapping and intracardiac echocardiography image guidance. Fluoroless transseptal puncture and catheter ablation were completed successfully in all cases, with no intraoperative complications. One patient required minimal use of fluoroscopy to visualize sheath advancement through an existing inferior vena cava filter. Procedural time was approximately 2.2 hours from transvenous access until case conclusion; transseptal access was obtained within 28 minutes of procedure initiation. Arrhythmia was found to recur in 27% of cases on average three months after the procedure. We demonstrate the safety and effectiveness of a completely fluoroless transseptal puncture and RF ablation technique that eliminates radiation exposure and enables complex electrophysiology procedures to be performed in a lead-free environment. |
| Databáze: | OpenAIRE |
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