Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Experimental methods D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-151 - Needless Transseptal Access (ID 469)

Disclosure
 A. Pacheco: Nothing relevant to disclose.

Abstract

Background: Transseptal Access (TA) technique should be part of the tools of dexterity that every electrophysiologist must develop, although it takes a wide learning curve and higher procedure cost.
Objective: Implement a new needless TA (NTA) technique.
Methods: Technique: Advance the sheath and dilator into the superior vena cava from a right femoral venous approach. Then pull the guide-wire to the tip of the dilator. Guided by fluoroscopy using right and left anterior oblique views, direct the sheath towards the inter-atrial septum, and then go down to the fossa ovalis. Our anatomic references were the coronary sinus and his catheters. The sheath is then advanced slightly to stretch the inter-atrial septum tissue with the tip of the introducer, push the wire to the left superior pulmonary vein; finally the sheath is advanced over it.
Results: Between June 2017 and December 2018, we realized 112 TA for different types of arrhythmias. NTA was achieved in 107 attempts (95.5% success rate), with 2 complications (1.2%, 1 transient ST elevation, 1 failed access). The time to access the left side was in a median of 2.5 min with 21 seconds of fluoroscopy.
Conclusion: The NTA seems to be a safe and reproducible technique.
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