Safety and effectiveness of radiofrequency-powered transseptal puncture with intracardiac echocardiography and pressure monitoring
10.18501/ija.2025.26.e5
- Author:
Kyunyeon KIM
;
You-mi HWANG
;
Jaehoon KIM
;
Donguk KIM
- Publication Type:Research
- From:International Journal of Arrhythmia
2025;26(1):e5-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background and Objectives:Transseptal punctures (TSPs) are usually performed during cardiac interventions. Due to the associated risks during various procedural steps, mastering the technique requires a standardized training process and a significant learning curve, built on extensive experience. This study aimed to evaluate the safety and effectiveness of radiofrequency (RF)-powered transseptal needles during electrophysiological procedures, with the ultimate goal of implementing standardized and safe TSP methods.
Methods:This study included all patients scheduled for atrial fibrillation catheter ablation requiring TSP for left atrial (LA) access from January to June 2024 at our centre. Preprocedural assessments included transthoracic echocardiography and cardiac computed tomography (CT). A dual-monitoring system with intracardiac echocardiography and pressure monitoring was used. Ten patients (male, n = 8; female, n = 2) underwent TSP using RF-powered needles without any complications.
Results:The average LA volume measured by CT was 216.9 cm 3 , and the average LA volume index was 55.2 mL/m 2 , indicating severe atrial enlargement. The RF-powered TSP needle allowed precise guidance and minimized the risk of injury to adjacent cardiac structures.The dual-monitoring system enhanced TSP safety and accuracy.
Conclusions:Assistive devices and coincidental imaging monitoring modalities can be beneficial in cases involving complex anatomical cardiac structures that require intricate TSP. The RF-powered needle can aid in redoing TSP procedures and those with anatomical difficulties and variations. A standardized guide for safe TSP tailored to a specific procedure is recommended to enhance procedural success and safety.
