The efficiency and safety of multidetector computed tomography‐guided transseptal puncture during atrial fibrillation catheter ablation
Abstract Background Transseptal puncture (TSP) is a crucial technique for catheter ablation of atrial fibrillation (AF). Although intracardiac echo (ICE) facilitates a safe and accurate TSP, it is not widely used in developing countries because of the expense. This study evaluated the efficiency and...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-02-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | https://doi.org/10.1002/joa3.12975 |
| _version_ | 1797321565858168832 |
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| author | Yi Lu Zhen Yuan Chunhui Liu Shenghui Ma Li Shu Zhejun Cai |
| author_facet | Yi Lu Zhen Yuan Chunhui Liu Shenghui Ma Li Shu Zhejun Cai |
| author_sort | Yi Lu |
| collection | DOAJ |
| description | Abstract Background Transseptal puncture (TSP) is a crucial technique for catheter ablation of atrial fibrillation (AF). Although intracardiac echo (ICE) facilitates a safe and accurate TSP, it is not widely used in developing countries because of the expense. This study evaluated the efficiency and safety of a novel cardiac multidetector computed tomography (MDCT)‐guided TSP during AF catheter ablation. Methods The study consisted of two cohorts. In the index cohort, TSP procedure was performed under the guidance of ICE, and we recorded the angulation of right anterior oblique of X‐ray projection. In the validation cohort, we compared the efficiency and safety of TSP guided by MDCT‐calculated angulation with propensity‐score‐matched patients who underwent TSP guided by ICE. Results We included 50 patients in the index cohort, and the mean angles of interatrial septum (IAS) measured from MDCT and ICE were 34.8 ± 6.3 and 35.1 ± 6.5, respectively. In the validation cohort, 376 patients were enrolled in the MDCT‐guided group and ICE‐guided group. Both groups had 1 case of cardiac tamponade. The mean axial plane angle was 35.46 ± 6.17 degrees, which was not influenced by age, gender, BMI, and LA size, while a moderate positive linear correlation between EF and the axial plane angle (R2 = 0.14, p = .006). Conclusion Cardiac MDCT can provide a clear vision of IAS orientation, and provide the appropriate RAO angle and height for TSP. The efficiency and safety of our MDCT‐guided TSP were comparable to ICE‐guided TSP, which may serve as an alternative method for TSP with ICE unavailable. |
| first_indexed | 2024-03-08T05:00:29Z |
| format | Article |
| id | doaj.art-7784f6726e3c4b15ab39c8cf06bec7f2 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-03-08T05:00:29Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-7784f6726e3c4b15ab39c8cf06bec7f22024-02-07T13:08:43ZengWileyJournal of Arrhythmia1880-42761883-21482024-02-0140111812310.1002/joa3.12975The efficiency and safety of multidetector computed tomography‐guided transseptal puncture during atrial fibrillation catheter ablationYi Lu0Zhen Yuan1Chunhui Liu2Shenghui Ma3Li Shu4Zhejun Cai5Department of Cardiology Second Affiliated Hospital of Zhejiang University School of Medicine, Cardiovascular Key Lab of Zhejiang Province Hangzhou Zhejiang ChinaDepartment of Cardiology Second Affiliated Hospital of Zhejiang University School of Medicine, Cardiovascular Key Lab of Zhejiang Province Hangzhou Zhejiang ChinaDepartment of Cardiology Second Affiliated Hospital of Zhejiang University School of Medicine, Cardiovascular Key Lab of Zhejiang Province Hangzhou Zhejiang ChinaDepartment of Cardiology Second Affiliated Hospital of Zhejiang University School of Medicine, Cardiovascular Key Lab of Zhejiang Province Hangzhou Zhejiang ChinaDepartment of Cardiology Second Affiliated Hospital of Zhejiang University School of Medicine, Cardiovascular Key Lab of Zhejiang Province Hangzhou Zhejiang ChinaDepartment of Cardiology Second Affiliated Hospital of Zhejiang University School of Medicine, Cardiovascular Key Lab of Zhejiang Province Hangzhou Zhejiang ChinaAbstract Background Transseptal puncture (TSP) is a crucial technique for catheter ablation of atrial fibrillation (AF). Although intracardiac echo (ICE) facilitates a safe and accurate TSP, it is not widely used in developing countries because of the expense. This study evaluated the efficiency and safety of a novel cardiac multidetector computed tomography (MDCT)‐guided TSP during AF catheter ablation. Methods The study consisted of two cohorts. In the index cohort, TSP procedure was performed under the guidance of ICE, and we recorded the angulation of right anterior oblique of X‐ray projection. In the validation cohort, we compared the efficiency and safety of TSP guided by MDCT‐calculated angulation with propensity‐score‐matched patients who underwent TSP guided by ICE. Results We included 50 patients in the index cohort, and the mean angles of interatrial septum (IAS) measured from MDCT and ICE were 34.8 ± 6.3 and 35.1 ± 6.5, respectively. In the validation cohort, 376 patients were enrolled in the MDCT‐guided group and ICE‐guided group. Both groups had 1 case of cardiac tamponade. The mean axial plane angle was 35.46 ± 6.17 degrees, which was not influenced by age, gender, BMI, and LA size, while a moderate positive linear correlation between EF and the axial plane angle (R2 = 0.14, p = .006). Conclusion Cardiac MDCT can provide a clear vision of IAS orientation, and provide the appropriate RAO angle and height for TSP. The efficiency and safety of our MDCT‐guided TSP were comparable to ICE‐guided TSP, which may serve as an alternative method for TSP with ICE unavailable.https://doi.org/10.1002/joa3.12975atrial fibrillationcardiac computed tomographyinteratrial septumintracardiac echotransseptal puncture |
| spellingShingle | Yi Lu Zhen Yuan Chunhui Liu Shenghui Ma Li Shu Zhejun Cai The efficiency and safety of multidetector computed tomography‐guided transseptal puncture during atrial fibrillation catheter ablation Journal of Arrhythmia atrial fibrillation cardiac computed tomography interatrial septum intracardiac echo transseptal puncture |
| title | The efficiency and safety of multidetector computed tomography‐guided transseptal puncture during atrial fibrillation catheter ablation |
| title_full | The efficiency and safety of multidetector computed tomography‐guided transseptal puncture during atrial fibrillation catheter ablation |
| title_fullStr | The efficiency and safety of multidetector computed tomography‐guided transseptal puncture during atrial fibrillation catheter ablation |
| title_full_unstemmed | The efficiency and safety of multidetector computed tomography‐guided transseptal puncture during atrial fibrillation catheter ablation |
| title_short | The efficiency and safety of multidetector computed tomography‐guided transseptal puncture during atrial fibrillation catheter ablation |
| title_sort | efficiency and safety of multidetector computed tomography guided transseptal puncture during atrial fibrillation catheter ablation |
| topic | atrial fibrillation cardiac computed tomography interatrial septum intracardiac echo transseptal puncture |
| url | https://doi.org/10.1002/joa3.12975 |
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