Trans-septal catheterization for radiofrequency catheter ablation of cardiac arrhythmias. Results and safety of a simplified method.
OBJECTIVE
This study reports on the results and safety of a simplified method of trans-septal catheterization for radiofrequency catheter ablation of cardiac arrhythmias.


RESULTS
Over 5 years, 411 patients underwent trans-septal catheterization for radiofrequency catheter ablation: 388 patients had a left-sided accessory pathway, 19 a left-sided focal atrial tachycardia, two atrial fibrillation and two post-infarction ventricular tachycardia. All but one patient with ventricular tachycardia underwent elective trans-septal catheterization. In the absence of a patent foramen ovale, puncture of the atrial septum was performed by using an 8F Mullins sheath and a Brockenbrough needle, according to the simplified method described in this paper. Trans-septal catheterization was accomplished in 383/388 patients (98.7%); in 41 patients a second trans-septal catheterization and radiofrequency catheter ablation was performed for initial failure or recurrence. Radiofrequency catheter ablation was successful in 96% of accessory pathway patients, 90% of atrial tachycardia patients, in both patients with atrial fibrillation and in both patients with ventricular tachycardia. No complication related to trans-septal catheterization was observed.


CONCLUSIONS
In experienced hands and according to the method described in this paper, the elective use of transseptal catheterization for radiofrequency catheter ablation in a large cohort of patients with cardiac arrhythmias is feasible, safe and allows successful ablation in the vast majority of the patients.
De Ponti
R
R
Università degli Studi di Pavia, Facoltà di Medicina e Chirurgia di Varese, Italy.
Zardini
M
M
Storti
C
C
Longobardi
M
M
Salerno-Uriarte
J A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D006328:Cardiac Catheterization / Q000295:instrumentation*; D017115:Catheter Ablation / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery; D006346:Heart Septum / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D013612:Tachycardia, Ectopic Atrial / Q000503:physiopathology / Q000601:surgery*; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery*; D017211:Treatment Failure