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Intracardiac echocardiography to guide transseptal left heart catheterization for radiofrequency catheter ablation.
J Cardiovasc Electrophysiol. 1999 Mar; 10(3):358-63.JC

Abstract

INTRODUCTION

The purpose of this study was to assess the feasibility and safety of intracardiac echocardiography to guide transseptal puncture for radiofrequency catheter ablation.

METHODS AND RESULTS

Transcatheter intracardiac echocardiography (9 MHz) was utilized to guide transseptal puncture in 53 patients undergoing radiofrequency catheter ablation. The anatomy and relationship of intra- and extracardiac structures were visualized with the ultrasound transducer positioned at the fossa ovalis. The tip of the transseptal dilator and tenting of the fossa ovalis and the left atrial wall were simultaneously visualized in a single ultrasound image in all patients. With maximum tenting of the fossa ovalis, the mean distance from the fossa to the left atrial wall was 11.9 +/- 5.8 mm (range: 1.8 to 25.6 mm). In four patients (8%), the tented fossa ovalis abutted the left atrial wall and the transseptal dilator was redirected with ultrasound guidance. Puncture of the interatrial septum was achieved through the fossa ovalis in each patient and required a single attempt in 51 patients (96%). The mean number of punctures per patient was 1.1 +/- 0.4. The mean time to perform transseptal catheterization was 18.2 +/- 6.8 minutes. There were no complications.

CONCLUSION

Intracardiac echocardiography delineated the anatomy of intra- and extracardiac structures not identified with fluoroscopy and simplified correct positioning of the transseptal dilator, puncture of the fossa ovalis, and cannulation of the left atrium in a timely and uncomplicated fashion.

Authors+Show Affiliations

Mid-Ohio Cardiology Research, Riverside-Methodist Hospital, Columbus, Ohio, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10210498

Citation

Daoud, E G., et al. "Intracardiac Echocardiography to Guide Transseptal Left Heart Catheterization for Radiofrequency Catheter Ablation." Journal of Cardiovascular Electrophysiology, vol. 10, no. 3, 1999, pp. 358-63.
Daoud EG, Kalbfleisch SJ, Hummel JD. Intracardiac echocardiography to guide transseptal left heart catheterization for radiofrequency catheter ablation. J Cardiovasc Electrophysiol. 1999;10(3):358-63.
Daoud, E. G., Kalbfleisch, S. J., & Hummel, J. D. (1999). Intracardiac echocardiography to guide transseptal left heart catheterization for radiofrequency catheter ablation. Journal of Cardiovascular Electrophysiology, 10(3), 358-63.
Daoud EG, Kalbfleisch SJ, Hummel JD. Intracardiac Echocardiography to Guide Transseptal Left Heart Catheterization for Radiofrequency Catheter Ablation. J Cardiovasc Electrophysiol. 1999;10(3):358-63. PubMed PMID: 10210498.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intracardiac echocardiography to guide transseptal left heart catheterization for radiofrequency catheter ablation. AU - Daoud,E G, AU - Kalbfleisch,S J, AU - Hummel,J D, PY - 1999/4/21/pubmed PY - 1999/4/21/medline PY - 1999/4/21/entrez SP - 358 EP - 63 JF - Journal of cardiovascular electrophysiology JO - J Cardiovasc Electrophysiol VL - 10 IS - 3 N2 - INTRODUCTION: The purpose of this study was to assess the feasibility and safety of intracardiac echocardiography to guide transseptal puncture for radiofrequency catheter ablation. METHODS AND RESULTS: Transcatheter intracardiac echocardiography (9 MHz) was utilized to guide transseptal puncture in 53 patients undergoing radiofrequency catheter ablation. The anatomy and relationship of intra- and extracardiac structures were visualized with the ultrasound transducer positioned at the fossa ovalis. The tip of the transseptal dilator and tenting of the fossa ovalis and the left atrial wall were simultaneously visualized in a single ultrasound image in all patients. With maximum tenting of the fossa ovalis, the mean distance from the fossa to the left atrial wall was 11.9 +/- 5.8 mm (range: 1.8 to 25.6 mm). In four patients (8%), the tented fossa ovalis abutted the left atrial wall and the transseptal dilator was redirected with ultrasound guidance. Puncture of the interatrial septum was achieved through the fossa ovalis in each patient and required a single attempt in 51 patients (96%). The mean number of punctures per patient was 1.1 +/- 0.4. The mean time to perform transseptal catheterization was 18.2 +/- 6.8 minutes. There were no complications. CONCLUSION: Intracardiac echocardiography delineated the anatomy of intra- and extracardiac structures not identified with fluoroscopy and simplified correct positioning of the transseptal dilator, puncture of the fossa ovalis, and cannulation of the left atrium in a timely and uncomplicated fashion. SN - 1045-3873 UR - https://www.unboundmedicine.com/medline/citation/10210498/Intracardiac_echocardiography_to_guide_transseptal_left_heart_catheterization_for_radiofrequency_catheter_ablation_ DB - PRIME DP - Unbound Medicine ER -