Zero-fluoroscopy transseptal puncture guided by right atrial electroanatomical mapping combined with intracardiac echocardiography: A single-center experience.

Abstract

BACKGROUND:

Right atrial electroanatomical mapping may be combined with SoundStar 3D diagnostic ultrasound catheter (EAM-ICE) as a zero-fluoroscopy procedure for radiofrequency catheter ablation (RFCA). We aimed to evaluate the efficiency and safety of zero-fluoroscopy transseptal puncture guided by EAM-ICE and fluoroscopy combined with intracardiac echocardiography (F-ICE) in patients with paroxysmal atrial fibrillation (PAF).

HYPOTHESIS:

Zero-fluoroscopy transseptal puncture is an effective and safe procedure.

METHODS:

This study had a prospective design. A total of 57 patients with PAF were enrolled and assigned to two groups. Twenty-seven patients were enrolled in the EAM-ICE group, and 30 patients were enrolled in the F-ICE group.

RESULTS:

There were no statistically significant differences in baseline patient characteristics between groups. Transseptal puncture was successful in all patients (57/57, 100%). Total procedure time and duration of transseptal puncture were lower in the F-ICE group (199.4 ± 26.0 minutes vs 150.7 ± 22.1 minutes, P = 0.000; 118.4 ± 19.7 vs 70.5 ± 13.5 minutes, P = 0.000). There was no use of fluoroscopy in the EAM-ICE group (0 mGy vs 70.5 ± 13.5 mGy); the duration of fluoroscopy in the EAM-ICE group was negligible (0 minutes vs 5.4 ± 1.9 minutes). No procedural complication occurred in either group.

CONCLUSIONS:

EAM-ICE guided zero-fluoroscopy transseptal puncture is an effective and safe procedure.

• Authors: Guangping Zhang, Liting Cheng, Zhuo Liang, Junmeng Zhang, Ruiqing Dong, Fei Hang, Xinlu Wang, Ziyu Wang, Lin Zhao, Zefeng Wang, Yongquan Wu
• Journal: Clinical cardiology (Clin Cardiol) Vol. 43 Issue 9 Pg. 1009-1016 (Sep 2020) ISSN: 1932-8737 [Electronic] United States
• PMID: 32506504 (Publication Type: Controlled Clinical Trial, Journal Article)
• Copyright: © 2020 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.

Topics

• Aged
• Atrial Fibrillation (diagnostic imaging, physiopathology, surgery)
• Atrial Septum (diagnostic imaging)
• Beijing
• Cardiac Catheterization (adverse effects)
• Catheter Ablation (adverse effects)
• Echocardiography
• Electrophysiologic Techniques, Cardiac
• Female
• Humans
• Male
• Middle Aged
• Predictive Value of Tests
• Prospective Studies
• Pulmonary Veins (diagnostic imaging, physiopathology, surgery)
• Punctures
• Radiography, Interventional
• Treatment Outcome