Improved left atrial catheterization efficiency and consistency using a novel steerable transseptal puncture sheath

Q3 Medicine Indian Pacing and Electrophysiology Journal Pub Date : 2024-01-01 DOI:10.1016/j.ipej.2023.10.001

Kimberly Berggren , Travis Lampert , Ajit H. Janardhan

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引用次数: 0

Abstract

Background

While steerable sheaths are widely used to improve catheter stability and contact force during radiofrequency (RF) catheter ablation in patients with atrial fibrillation (AF), steerable sheaths are less commonly used during transseptal puncture. This study evaluated whether left atrial catheterization efficiency can be improved using the VersaCross combined steerable sheath and transseptal system compared to previous standard workflow.

Methods

This study retrospectively analyzed AF ablation performed using the VersaCross Workflow consisting of VersaCross steerable sheath and RF wire for transseptal puncture and catheter ablation (VCW) to the standard workflow using a fixed curve sheath with RF needle followed by exchange for an Agilis steerable sheath for catheter ablation (STW).

Results

Thirty patients underwent RF ablation for paroxysmal or persistent AF, 15 using the VCW and 15 using the STW. Transseptal puncture time was 10.8 mins faster with the VCW compared to the standard workflow (20.9 ± 5.9 min vs. 31.7 ± 15.1 min; p = 0.024). Time to left atrial catheterization was 40% faster with the VCW compared to the STW (21.3 ± 5.8 min vs. 35.2 ± 14.4 min; p = 0.003). Overall procedure time was 14.2 min faster in the VCW compared to the STW (86.3 ± 16.1 min vs. 100.5 ± 19.3 min; p = 0.044).

Conclusions

Use of the VersaCross steerable system significantly reduced time to transseptal puncture, time to left atrial catheterization, and overall RF ablation time.

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使用新型可控经中隔穿刺鞘提高左心房导管的效率和一致性。

背景：虽然可操纵鞘被广泛用于改善心房颤动（AF）患者射频（RF）导管消融过程中的导管稳定性和接触力，但可操纵鞘在经中隔穿刺过程中不太常用。本研究评估了与以前的标准工作流程相比，使用VersaCross组合可控鞘管和经中隔系统是否可以提高左心房导管插入术的效率。方法：本研究回顾性分析了使用VersaCross工作流程进行的房颤消融术，该工作流程由VersaCrosss可操纵鞘和射频导线组成，用于经中隔穿刺和导管消融术（VCW），按照标准工作流程，使用带射频针的固定曲线鞘，然后更换Agilis可操纵护套用于导管消融剂（STW）。结果：30名患者接受了射频消融术对于阵发性或持续性AF，15使用VCW，15使用STW。与标准工作流程相比，VCW的房间隔穿刺时间快10.8分钟（20.9 ± 5.9分钟对31.7分钟 ± 15.1分钟；p = 0.024）。与STW相比，VCW左心房导管插入术的时间快40%（21.3 ± 5.8分钟对35.2分钟 ± 14.4分钟；p = 0.003）。与STW（86.3 ± 16.1分钟对100.5分钟 ± 19.3分钟；p = 0.044）。结论：VersaCross可控系统的使用显著缩短了经中隔穿刺时间、左心房导管插入术时间和整体射频消融时间。

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来源期刊

Indian Pacing and Electrophysiology Journal Medicine-Cardiology and Cardiovascular Medicine

CiteScore

2.20

自引率

0.00%

发文量

审稿时长

61 days

期刊介绍： Indian Pacing and Electrophysiology Journal is a peer reviewed online journal devoted to cardiac pacing and electrophysiology. Editorial Advisory Board includes eminent personalities in the field of cardiac pacing and electrophysiology from Asia, Australia, Europe and North America.