Facilitating Difficult Transseptal Advancement of a Large Diameter Sheath in the Left Atrium during Cryoballoon Ablation for Atrial Fibrillation

 

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:

Other cryoballoon ablation articles available at http://www.invasivecardiology.com:

 

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