By Giulio Conte, MD, Gian-Battista Chierchia, MD and Pedro Brugada, MD, PhD
(Cardiovascular Division, UZ Brussel-VUB, Brussels, Belgium)
PV isolation by means of cryoballoon (CB) ablation is becoming an increasingly popular procedure for the treatment of paroxysmal atrial fibrillation refractory to antiarrhythmic drugs. Nowadays, CB ablation is performed by obtaining a single transseptal (TS) access and positioning a 15 Fr outer diameter sheath (FlexCath; Medtronic) in the left atrium (LA).
In some cases, advancement of a big diameter sheath, such as the FlexCath, in the LA can be challenging as the resistance of the septum can potentially lead to a higher risk of complications due to the increased force when pushing the TS apparatus across into the LA. Facilitating this maneuver by means of a classical steerable electrophysiology catheter placed through the TS access, bent maximally and pulled down in order to widen the TS access, might be helpful and safe in these cases.
Read the entire article at:
- Conte G, Chierchia GB, Brugada P. A useful trick for difficult transseptal access during cryoballoon ablation for atrial fibrillation. J Invasive Cardiol. 2014 Feb;26(2):E17.
Other cryoballoon ablation articles available at http://www.invasivecardiology.com:
- Mandell J, Amico F, Parekh S, Snow J, Germano J, Cohen TJ. Early Experience With the Cryoablation Balloon Procedure for the Treatment of Atrial Fibrillation by an Experienced Radiofrequency Catheter Ablation Center. J Invasive Cardiol. 2013 Jun;25(6):288-92.
- Kocheril AG. Catheter Ablation of Atrial Fibrillation: Do the Newer Tools Help? J Invasive Cardiol. 2011 Oct;23(10):415-6.
- Darge A, Reynolds MR, Germano JJ. Advances in Atrial Fibrillation Ablation. J Invasive Cardiol. 2009 May;21(5):247-54.