Initial experience using a radiofrequency powered transseptal needle.
BACKGROUND
The purpose of this study was to determine the safety and efficacy of using a novel radiofrequency (RF) powered transseptal needle to perform transseptal puncture (TSP).


METHODS
TSP was performed in 35 consecutive patients undergoing left-sided catheter ablation (mean age = 51 years; male = 71%) using a RF powered transseptal needle (NRG, Adult Large and Standard Curve C1, 71 cm, Baylis Medical Company, Inc.). Prior TSP had been performed in 34% of patients. The transseptal apparatus was positioned with the tip of the dilator engaged in the fossa ovalis. RF energy was delivered to the tip of the transseptal needle using a proprietary RF generator at 10 W for 2 seconds as gentle pressure was applied to the needle.


RESULTS
In 5 of the 41 TSPs, the needle crossed into the left atrium before RF energy was delivered. In 35 of the remaining 36 punctures, the needle was successfully advanced into the left atrium after application of RF current. In 1 patient, the TSP with the powered needle was unsuccessful but was accomplished using a standard needle. The only complication was a transient right atrial thrombus, which occurred in 2 patients.


CONCLUSIONS
A radiofrequency powered transseptal needle can be used to perform TSP safely and successfully without the need for significant mechanical force, even in patients who have undergone TSP previously. Additional studies are needed to determine whether a powered transseptal needle should be used routinely.
Smelley
Matthew P
MP
Section of Cardiology, Department of Internal Medicine, University of Chicago, Chicago, Illinois, USA.
Shah
Dipak P
DP
Weisberg
Ian
I
Kim
Susan S
SS
Lin
Albert C
AC
Beshai
John F
JF
Burke
Martin C
MC
Knight
Bradley P
BP
D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006346:Heart Septum / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D010865:Pilot Projects; D011677:Punctures / Q000295:instrumentation*; D016896:Treatment Outcome; D055815:Young Adult