scholarly journals Zero‐fluoroscopy transseptal puncture guided by right atrial electroanatomical mapping combined with intracardiac echocardiography: A single‐center experience

2020 ◽  
Vol 43 (9) ◽  
pp. 1009-1016
Author(s):  
Guangping Zhang ◽  
Liting Cheng ◽  
Zhuo Liang ◽  
Junmeng Zhang ◽  
Ruiqing Dong ◽  
...  
Keyword(s):  
Intracardiac Echocardiography ◽  
Right Atrial ◽  
Transseptal Puncture ◽  
Electroanatomical Mapping ◽  
Single Center ◽  
Single Center Experience ◽  
Zero Fluoroscopy

scholarly journals Study on the Curative Effect and Safety of Radiofrequency Catheter Ablation of Paroxysmal Atrial Fibrillation via Zero-Fluoroscopy Transseptal Puncture under the Dual Guidance of Electroanatomical Mapping and Intracardiac Echocardiography

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Fei Hang ◽  
Liting Cheng ◽  
Zhuo Liang ◽  
Ruiqing Dong ◽  
Xinlu Wang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Radiofrequency Catheter Ablation ◽  
Intracardiac Echocardiography ◽  
Transseptal Puncture ◽  
Electroanatomical Mapping ◽  
Curative Effect ◽  
Significant Difference ◽  
Zero Fluoroscopy

Aims. 3D electroanatomical mapping combined with intracardiac echocardiography- (EAM-ICE-) guided transseptal puncture has been proven safe and effective during the radiofrequency catheter ablation (RFCA) procedure used to treat paroxysmal atrial fibrillation (PAF). In this study, we aimed to compare the curative effect and safety of RFCA via F (fluoroscopy) and zero-fluoroscopy transseptal puncture guided by EAM-ICE in patients with PAF. Methods and Results. A prospective study in which 110 patients with PAF were included and assigned to two groups was conducted. Fifty-five (50%) patients were enrolled in the EAM-ICE group, whereas the other 55 (50%) patients were enrolled in the F group. There were no significant differences in baseline characteristics between the two groups. The transseptal duration time was longer in the EAM-ICE group (19.8 ± 3.0 min vs. 8.6 ± 1.2 min, p ≤ 0.01 ); however, fluoroscopy was not used in the EAM-ICE group compared with the F group (0 mGy vs. 109.1 ± 57.9 mGy). Similarly, there was also no significant difference in the recurrence rate of atrial fibrillation between the EAM-ICE and F groups (25.5% vs. 18.2%, p = 0.356 ). Conclusion. RFCA via EAM-ICE-guided zero-fluoroscopy transseptal puncture in patients with PAF is safe and effective for long-term follow-up.

scholarly journals Initial Experience Using the Radiofrequency Needle Visualization on the Electroanatomical Mapping System for Transseptal Puncture

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Silvia Guarguagli ◽  
Ilaria Cazzoli ◽  
Aleksander Kempny ◽  
Michael A. Gatzoulis ◽  
Sabine Ernst
Keyword(s):  
Transseptal Puncture ◽  
Electroanatomical Mapping ◽  
Access Route ◽  
Effective Technique ◽  
Mapping System ◽  
Single Operator ◽  
Unselected Group ◽  
Radiation Time ◽  
Electroanatomical Mapping System ◽  
Zero Fluoroscopy

Introduction. Transseptal puncture (TSP) is a routine access route in patients with left-sided ablation substrates and is performed safely on fluoroscopy (+/− echocardiographic guidance). We report on our experience using a radiofrequency (RF) needle in an unselected group of patients to demonstrate safety and usefulness of direct tip visualization on the 3D electroanatomical mapping (EAM) system with specific emphasis on total radiation exposure. Methods and Results. We retrospectively reviewed 42 consecutive left-sided ablation procedures with TSP performed using an RF needle guided by fluoroscopy and/or EAM visualization by a single operator. The procedures included atrial fibrillation (n = 33), atrial tachycardia (n = 8), and ventricular tachycardia (n = 1) ablations. Fourteen of 41 patients had congenital heart disease, including 9 patients with previous septal closure. Twenty-two patients had at least one previous TSP. All TSPs were performed successfully and without complications. The overall median fluoroscopy time amounted to 3.2 min and median exposure of 199.5 µGy∗m2. In a subgroup of patients (n = 27), the RF needle was visualized on the EAM system: median radiation time was 0.88 (interquartile range: 0–3.4) min and median exposure 33.5 [0–324.8] µGy∗m2. Conclusions. TSP using an RF needle is an effective technique, also in congenital patients with artificial patch material and in normal patients with multiple previous TSPs. Moreover, the RF needle tip visualization on EAM allows a low (or even zero) fluoroscopy approach.

scholarly journals Zero-Fluoroscopy Cardiac Ablation: Technology Is Moving Forward in Complex Procedures—A Novel Workflow for Atrial Fibrillation

Biology ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1333
Author(s):  
Matteo Bertini ◽  
Graziella Pompei ◽  
Paolo Tolomeo ◽  
Michele Malagù ◽  
Alessio Fiorio ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Gold Standard ◽  
Intracardiac Echocardiography ◽  
The Other ◽  
Transseptal Puncture ◽  
Healthcare Staff ◽  
Af Ablation ◽  
Mapping System ◽  
Long Time ◽  
Zero Fluoroscopy

Background and Rationale. A fluoroscopy-based approach to an electrophysiological procedure is widely validated and has been recognized as the gold standard for a long time. The use of fluoroscopy exposes both the healthcare staff and the patient to a non-negligible dose of radiation. To minimize the risks associated with the use of fluoroscopy, it would be reasonable to perform ablation procedures with zero fluoroscopy. This approach is widely used in simple ablation procedures, but not in complex procedures. In atrial fibrillation (AF) ablation procedures, fluoroscopy remains the main technology used, in particular to guide the transseptal puncture. Main results and Implications. We present a workflow to perform a complete zero-fluoroscopy ablation for AF ablation procedures using a 3D electro-anatomical mapping system, intracardiac echocardiography and a novel steerable guiding sheath that can be visualized on the mapping system. We present two cases, one with paroxysmal AF and the other one with persistent AF during which we applied this novel workflow achieving a successful pulmonary vein isolation without complications and complete zero-fluoroscopy exposure.

scholarly journals Late Retrieval of the Leadless Micra Transcatheter Pacemaker System

2021 ◽  
Vol 04 (06) ◽  
pp. 01-13
Author(s):  
Kentaro Minami
Keyword(s):  
Success Rate ◽  
Biventricular Pacing ◽  
Intracardiac Echocardiography ◽  
Surrounding Tissue ◽  
Single Center ◽  
Single Patient ◽  
Cardiac Wall ◽  
Single Center Experience ◽  
Pacemaker Syndrome ◽  
Leadless Pacing

Aim: We report our single-center experience with the retrieval and replacement of the chronically implanted Micra transcatheter pacing system (TPS). Material and Methods: We included 6 patients with an implanted the Micra TPSs who subsequently underwent transvenous method of retrieval at our institution. The indication for device retrieval was pacemaker syndrome in two patients, battery depletion in three patients, and need for upgrade to biventricular pacing in one patient. Results: After an implantation duration of 555 ± 373 days, the overall retrieval success rate was 83.3%, 5 of 6 patients. No procedure-related adverse device events occurred. In the single patient with unsuccessful retrieval, intracardiac echocardiography revealed that the Micra TPS was embedded within the cardiac wall and surrounding tissue. After retrieval, four patients received a new Micra TPS. Conclusions: Late retrieval of an implanted Micra TPS was safe and feasible, which indicates the possibility for their safe and elective replacement with a new leadless pacing device.

scholarly journals Ablation with zero‐fluoroscopy of premature ventricular complexes from aortic sinus cusps: A single‐center experience

2021 ◽  
Author(s):  
Pablo J. Sánchez‐Millán ◽  
Guillermo Gutiérrez‐Ballesteros ◽  
Manuel Molina‐Lerma ◽  
Rosa Macías‐Ruiz ◽  
Juan Jiménez‐Jáimez ◽  
...  
Keyword(s):  
Single Center ◽  
Aortic Sinus ◽  
Premature Ventricular Complexes ◽  
Single Center Experience ◽  
Zero Fluoroscopy
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