Exploration of a method for transseptal puncture guided by intracardiac echocardiography using visual adjustable curved sheath and surgical electrocautery
Objectives To explore a new method of transseptal puncture guided by intracardiac echocardiography using visually adjustable curved sheath and surgical electrocautery.Methods Patients who underwent atrial fibrillation radiofrequency ablation using a combination of ICE-guided visual adjustable curved sheath and high-frequency electric knife underwent atrial septal puncture.By reviewing baseline characteristics,atrial septal puncture characteristics,and postoperative follow-up data,the short-term safety and effectiveness of the ICE-guided visual adjustable curved sheath combined with high-frequency electric knife atrial septal puncture method were observed.A total of 20 patients with atrial fibrillation who underwent radiofrequency ablation in the First Affiliated Hospital of Xi'an Jiaotong University from May 1st,2023 to June 1st,2023 were included in the study.Results Twenty patients were included,with 10(50％)of them being male and an average ageof(60.85±7.07)years old,and a BM1 of 24.06±3.23.Two(10％)of the patients hadconcomitant cardiomyopathy and valve disease,while 8(40％)had abnormal atrial septal structure.The anterior posterior diameter of the left atrium was(34.00±7.19)mm.The time of atriaseptal puncture was(6.10±3.46)minutes,and the number of punctures was 1 in 16(80％)cases and 2 in 4(20％)cases.All TSPs were completed.with the distance betweenthe puncture point and the lowest point of the right lower pulmonary vein being(18.95±2.56)mm.After the procedure,nothrombosis was found in any of thesheaths or guide wires,and no damage was found at the tip of thesheaths.A 24-hour follow-up UCGshowed a small amount ofpericardial effusion in one patient,which was stillpresent after 5 months.There were no recurrent cerebra infarctionsor other embolic events observed during the 24-hour and 5-month follow-up after the surgery.Conclusions ICE-guided Transseptal puncture combined with visualized adjustable sheaths and electrophysiology is easily performed,with safety、precisionandand high efficacy in Short-term observation.
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