A Simplified Trans-Septal Puncture Technique using a Needle Free Approach for Cryoablation of Atrial Fibrillation

Adam J Graham, Shohreh Honarbakhsh, Ben O'Brien, Richard J Schilling, Adam J Graham, Shohreh Honarbakhsh, Ben O'Brien, Richard J Schilling

Abstract

Background: Trans-septal puncture (TSP) is routinely performed during treatment of atrial fibrillation (AF) and other electrophysiology procedures. The purpose of this retrospective observational study was the analysis of a novel needle free technique employed to gain access to the left atrium (LA).

Methods: The SafeSept Needle Free guidewire was delivered, using no needle, to the interatrial septum via a standard cryoablation sheath and dilator under transoesophageal guidance. The wire was then advanced into the LA with position confirmed by fluoroscopy. All cases were performed under general anaeasthetic (GA).

Results: The novel procedure was performed in 43 patients (38 paroxysmal AF (88.4%) and 5 persistent AF (11.4%)) with 100% success rate in accessing the LA. The procedure times (51.70 ±18.18) and fluoroscopy times (2.75 ± 3.35) were recorded. There were no complications seen in the cohort.

Conclusion: Using SafeSept Needle Free wire for TSP had a high success rate and resulted in no complications, with the potential to reduce procedure and fluoroscopy times.

Keywords: Atrial Fibrillation; Cryoablation; Needle-Free; Safe-Sept; Trans-septal puncture.

Figures

Figure 1.. Schematic view of the use…
Figure 1.. Schematic view of the use of the Needle Free SafeSept wire to cross the atrial septum
Figure 2.. Transoesophageal echocardiography views demonstratetenting of…
Figure 2.. Transoesophageal echocardiography views demonstratetenting of the inter-atrial septum (left) and subsequent advancement into the left atrium (right)

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Source: PubMed

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