Li C, Zhang J, Li S, Sang C, Liu N, Du X, Dong J, Ma C. A novel and easy approach to
difficult transseptal puncture during atrial fibrillation ablation.
J Interv Card Electrophysiol 2021;
62:269-76. [PMID:
33034794 DOI:
10.1007/s10840-020-00891-y]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
AIMS
Transseptal passage is sometimes difficult to obtain. This study evaluates the feasibility and safety of a novel and easy transseptal puncture (TSP) technique named 2D2G (using two dilators and two guidewires) in patients with difficult TSP.
METHODS AND RESULTS
Forty-four paroxysmal atrial fibrillation patients with difficult TSP were enrolled in this study. They were allocated to the 2D2G group or the conventional group in a 1:1 fashion. The primary endpoint in both groups was successful TSP without changing the puncture site or using auxiliary tools. The secondary endpoints were the safety, total transseptal puncture time, and ablation time. There were no differences in baseline demographic or clinical characteristics between the two groups. Successful LA access in the 2D2G group was 100% (vs. 64%, P < 0.05). The total TSP time (10 ± 3 min vs. 5 ± 1 min, P < 0.05) and ablation time (42 ± 19 min vs. 58 ± 22 min, P < 0.05) in the conventional group were significantly longer than those in the 2D2G group. No major complications occurred in either group, and all the patients underwent successful circumferential pulmonary vein isolation (CPVI).
CONCLUSION
In AF patients with difficult TSP, the 2D2G technique is safe, feasible, and time-saving.
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