Display options
Cite
Arkles J, Zado E, Supple G, et al. Feasibility of Transseptal Access in Patients With Previously Scarred or Repaired Interatrial Septum. J Cardiovasc Electrophysiol. 2015;26(9):963-968doi: 10.1111/jce.12730.
Arkles, J., Zado, E., Supple, G., Frankel, D. S., Callans, D., Marchlinski, F., & Dixit, S. (2015). Feasibility of Transseptal Access in Patients With Previously Scarred or Repaired Interatrial Septum. Journal of cardiovascular electrophysiology, 26(9), 963-968. https://doi.org/10.1111/jce.12730
Arkles, Jeffrey, et al. "Feasibility of Transseptal Access in Patients With Previously Scarred or Repaired Interatrial Septum." Journal of cardiovascular electrophysiology vol. 26,9 (2015): 963-968. doi: https://doi.org/10.1111/jce.12730
Arkles J, Zado E, Supple G, Frankel DS, Callans D, Marchlinski F, Dixit S. Feasibility of Transseptal Access in Patients With Previously Scarred or Repaired Interatrial Septum. J Cardiovasc Electrophysiol. 2015 Sep;26(9):963-968. doi: 10.1111/jce.12730. Epub 2015 Aug 17. PMID: 26075504.
Copy Download .nbib Format: NLM
Share it on

J Cardiovasc Electrophysiol. 2015 Sep;26(9):963-968. doi: 10.1111/jce.12730. Epub 2015 Aug 17.

Feasibility of Transseptal Access in Patients With Previously Scarred or Repaired Interatrial Septum.

Journal of cardiovascular electrophysiology

Jeffrey Arkles, Erica Zado, Gregory Supple, David S Frankel, David Callans, Francis Marchlinski, Sanjay Dixit

Affiliations

  1. Electrophysiology Section, Cardiovascular Division, Temple University Hospital, Philadelphia, Pennsylvania, USA.
  2. Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

PMID: 26075504 DOI: 10.1111/jce.12730

Abstract

BACKGROUND: Many patients (pts) with interatrial septal repair (ASR) and/or multiple prior transseptal puncture (MTSP) are being referred for atrial fibrillation (AF) ablation. We examine the feasibility of repeat TSP in these settings.

METHODS: Records were reviewed from a single center from 2001 to 2012. Criteria for MTSP were >2 priorAF ablation procedures and criteria for ASR were prior surgical or percutaneous interatrial septal repair. Intracardiac echocardiography (ICE) was used for all procedures. Repeat transseptal puncture (TSP) outcomes were classified as (1) routine, (2) challenging (additional tools, sheaths, multiple attempts), (3) failed, or (4) complicated (adverse event possibly related to TSP). Five hundred pts selected at random over the same time period undergoing 1st AF ablation without history of prior cardiac surgery were used as control.

RESULTS: Two hundred and fifty-one pts met the criteria (MTSP = 224; ASR = 27). TSP was routinely accomplished in the majority (212 pts [95%] in MTSP; 20 pts [74%] in ASR). In the MTSP group, the number of challenging/failed cases increased proportionately with number of prior AF ablation procedures. There were no complications in the ASR group and 2 (1%) in MTSP. This was not different from that in the control arm (n = 6 [1%]; P = ns). Pericardial effusion was the only complication seen in all groups.

CONCLUSIONS: In the majority of pts with scarred and/or repaired IAS, repeat TSP can be routinely accomplished using ICE guidance without any other special tools. Although repeat TSP can be occasionally difficult in pts with MTSP and ASR, it can be accomplished in the majority without serious complications.

© 2015 Wiley Periodicals, Inc.

Keywords: atrial fibrillation; catheter ablation; interatrial septum; intracardiac echocardiography; transseptal puncture

Publication Types