title: Does the age affect the fluoroscopy-guided transseptal puncture in catheter ablation of atrial fibrillation?
abstract: BACKGROUND
  The anatomical differences with age may raise difficulty in determining the proper positioning of the transseptal puncture site in the therapeutic left heart catheterization. This study investigated whether age affects the fluoroscopy-guided transseptal puncture in the catheter ablation of atrial fibrillation.
  
  
  RESULTS
  Fifty patients (52 +/- 12 years, 35 men) who underwent ablation for paroxysmal/persistent atrial fibrillation were included. The patients were divided into two groups according to their age (cut-point 50 y/o): young group (n = 20) and old group (n = 30). In the 30 degrees right anterior oblique view (RAO), the width between the transseptal puncture site and coronary sinus ostium (H (N-CSO)) was longer in old-age group (14.4 +/- 9.4 vs 10.9 +/- 10.4 mm, P = 0.034). In the 60 degrees left anterior oblique view (LAO) view, the angle of the direction of the transseptal needle (N-angle) was less in the old-age group (56.0 +/- 10.0 degrees vs 58.4 +/- 9.8 degrees , P = 0.041). The ratio of the transseptal puncture site-coronary sinus ostium (CSO) distance over the distance between the superior vena cava-right atrial junction and CSO (V(N-CSO)/V(J-CSO)) was significantly higher in the old-age group (0.73 +/- 0.12 vs 0.63 +/- 0.2, P = 0.009).
  
  
  CONCLUSIONS
  The transseptal puncture site in the RAO view moved higher and more posterior and the transseptal puncture angle in the LAO view decreased with age. These findings highlight the influence of age on the atrial anatomy and transseptal puncture site.
authors: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Institute of Clinical Medicine, Taipei, Taiwan.
authors: Yu-Feng
authors: YF
authors: Hu
authors: Ching-Tai
authors: CT
authors: Tai
authors: Yenn-Jiang
authors: YJ
authors: Lin
authors: Shih-Lin
authors: SL
authors: Chang
authors: Li-Wei
authors: LW
authors: Lo
authors: Wanwarang
authors: W
authors: Wongcharoen
authors: Ameya R
authors: AR
authors: Udyavar
authors: Ta-Chuan
authors: TC
authors: Tuan
authors: Shih-Ann
authors: SA
authors: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006346:Heart Septum / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures; D018709:Statistics, Nonparametric; D016896:Treatment Outcome