This is an observational study conducted during one year in 8 centers specialized in ablation techniques requiring a trans-septal approach. The following data were collected amongst other things: time required for trans-septal catheterization, length of the FO to the LA wall before advancement of the trans-septal dilator, distance when maximum tenting of the FO by the trans-septal dilator, complications occurring during or at distance from the procedure.
The study population included 123 patients (M 72%; mean age 60±10 years). Median times were as following: to prepare ICE catheter, 70 sec (38; 115); to insert ICE into the sheath, 40 sec (21; 88); to reach the LA, 153 sec (69; 310); time of fluoroscopy duration was 142 sec (80;256). Length of the FO was 16 ± 5 mm, distance from the FO to the LA wall before advancement of the trans-septal dilator was 29 ± 9 mm, distance when maximum tenting of the FO by the trans-septal dilator 15.9 ± 9 mm. Pericardial effusions occurred in 10 patients: 1 severe tamponade necessitating pericardial puncture (FO was not visible with ICE), 6 moderate per procedure and 3 light delayed pericardial effusions (not related to trans septal puncture).
This observational study shows that ICE does not add a long additional time to ablation procedure. It gives a direct indication of the position of the FO and the length of the LA. Although a tamponade occurred in one patient (0.8%), this technique is helpful in procedures requiring a transseptal approach.
The author hereby declares no conflict of interest