Evasion maneuver for transseptal approach during cryoballoon pulmonary vein isolation
PURPOSE: Pulmonary vein isolation (PVI) is a cornerstone therapy in patients with symptomatic atrial fibrillation. One current method is performing a PVI using a cryoballoon (CB). The CB is inserted into the left atrium via a steerable sheath. However, at times, passing of the interatrial septum by...
| Publié dans: | Journal of the Saudi Heart Association. - 1999. - 30(2018), 4 vom: 01. Okt., Seite 301-304 |
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| Auteur principal: | |
| Autres auteurs: | , , , , |
| Format: | Article en ligne |
| Langue: | English |
| Publié: |
2018
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| Accès à la collection: | Journal of the Saudi Heart Association |
| Sujets: | Journal Article Coronary sinus catheter Cryoballoon Pulmonary vein isolation Transseptal approach |
| Résumé: | PURPOSE: Pulmonary vein isolation (PVI) is a cornerstone therapy in patients with symptomatic atrial fibrillation. One current method is performing a PVI using a cryoballoon (CB). The CB is inserted into the left atrium via a steerable sheath. However, at times, passing of the interatrial septum by the sheath is hindered, e.g., due to septal fibrosis. Here we report our experience with an evasion maneuver to facilitate this approach using a 6F multipolar and steerable coronary Sinus catheter (CS) for predilatation of the interatrial septum METHODS AND RESULTS: We report 10 patients undergoing a CB-PVI, where the investigator experienced difficulties in passing the interatrial septum with the CB sheath. In these cases, after three conventional abortive attempts, we predilated the transseptal puncture site using both the CS catheter and the dilatator of the CB sheath. Thereafter access of the CB sheath to the left atrium could be achieved instantly and without further resistance CONCLUSION: We report a safe and feasible maneuver to facilitate transseptal access with the CB steerable sheath in cases complicated by excessive interatrial resistance |
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| Description: | Date Revised 18.03.2022 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
| ISSN: | 1016-7315 |
| DOI: | 10.1016/j.jsha.2018.05.002 |