title: Comparison of a radiofrequency powered flexible needle with a classic rigid Brockenbrough needle for transseptal punctures in terms of safety and efficacy.
abstract: BACKGROUND
  This study aimed to evaluate the safety and efficacy of utilising an innovative radiofrequency (RF) powered flexible needle to achieve transseptal puncture (TSP).
  
  
  RESULTS
  A RF powered flexible needle (Toronto catheter, Baylis Medical Company Inc.) associated with a stiffer dilator (Torflex Superstrong, Baylis Medical Company Inc.) was used in 125 consecutive patients referred for left sided ablations (mean age=55.6, male=86.5%) and compared with a standard transseptal set (BRK needle, SL0 sheath and dilator, St Jude Medical, Inc.) used in the previous 100 patients (mean age=56, male 82%). TSP was achieved in 95/100 patients in the Brockenbrough group and in all 125 patients in the Toronto group (p=0.01) despite an equivalent proportion of difficult situations (8 and 9% respectively) and patients with a prior TSP (17% vs 24%). 7/100 needle related events (failure, aborted attempt or pericardial effusion) occurred in the Brockenbrough group and none in the Toronto group (p=0.01). The Toronto needle crossed the septum at the first attempt in 123/125 (98.4%) patients and the Brockenbrough needle in 84/95 (88%) patients (p<0.001).
  
  
  CONCLUSIONS
  Our data suggest that the Toronto RF powered flexible needle is safer and more efficient than a standard Brockenbrough needle and can be used not only in difficult situations but routinely to achieve TSP.
authors.affiliation: Clinique Ambroise PARE, 92200 Neuilly Sur Seine, France. Electronic address: gael.jauvert@wanadoo.fr.
authors.forename: Gaël
authors.initials: G
authors.lastname: Jauvert
authors.affiliation: Clinique Ambroise PARE, 92200 Neuilly Sur Seine, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Grimard
authors.affiliation: Clinique Ambroise PARE, 92200 Neuilly Sur Seine, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Lazarus
authors.affiliation: Clinique Ambroise PARE, 92200 Neuilly Sur Seine, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Alonso
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D009864:Ontario; D011677:Punctures / Q000295:instrumentation*
keywords: Ablations; Safety; Transseptal punctures