Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO02 - Poster Session II (ID 47) Poster

D-PO02-123 - A Comparison Between 3d Mapping-guided And Ice-guided Transseptal Catheterization (ID 1018)

Abstract

Background: Transseptal catheterization (TC) is routinely performed in left atrial (LA) ablation procedures. Transseptal puncture (TSP) guided by intracardiac echocardiogram (ICE) is often performed to gain access to the LA. Although ICE may improve the safety and efficacy of TSP, it significantly increases the cost of the procedure. A 3-D electroanatomical mapping system is frequently used in LA ablation procedures and can be used to identify the patent foramen ovale (PFO) during mapping of the right atrium. The ability to visualize the tip of the transseptal needle on a 3-D map of the right atrium can be used to guide transseptal puncture.
Objective: This study aims to compare safety and efficacy between 3-D mapping-guided and ICE-guided TC.
Methods: We prospectively studied TC in 99 patients who underwent left atrial ablation procedures. Needle time, fluoroscopic time, success rate and complications were compared between both groups. Needle time is defined as the time from when TSP needle is inserted into the sheath to when the sheath is successfully placed in the left atrium and the needle is removed.
Results: TC was successfully performed in all patients in both groups without any complications. TC was achieved by TSP in 66 patients in the ICE group and 33 patients in the 3-D mapping group. Median needle time was 4.8 (IQR 3.2-7.2) vs. 3.1 (IQR 2.1-4.2) minutes (p < 0.05) and median fluoroscopic time was 1.5 (IQR 0.8-2.5) vs. 0.1 (IQR 0.1-0.3) minutes (p < 0.05) in the ICE group and 3-D mapping group, respectively.
Conclusion: Transseptal catheterization can be safely and successfully achieved using both ICE and a 3-D mapping system. Needle time, fluoroscopic time and cost were significantly lower in the 3-D mapping group.
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