Universität zu Köln

Blockhaus, Christian, Waibler, Hans-Peter, Guelker, Jan-Erik, Klues, Heinrich, Bufe, Alexander and Shin, Dong-In (2018). Evasion maneuver for transseptal approach during cryoballoon pulmonary vein isolation. J. Saudi Heart Assoc., 30 (4). S. 301 - 305. AMSTERDAM: ELSEVIER SCIENCE BV. ISSN 2212-5043

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Abstract

Purpose: Pulmonary vein isolation (PVI) is a cornerstone therapy in patients with symptomatic atrial fibrillation. One current method is performing a PVI using a cryoballoon (CB). The CB is inserted into the left atrium via a steerable sheath. However, at times, passing of the interatrial septum by the sheath is hindered, e.g., due to septal fibrosis. Here we report our experience with an evasion maneuver to facilitate this approach using a 6F multipolar and steerable coronary Sinus catheter (CS) for predilatation of the interatrial septum. Methods and results: We report 10 patients undergoing a CB-PVI, where the investigator experienced difficulties in passing the interatrial septum with the CB sheath. In these cases, after three conventional abortive attempts, we predilated the transseptal puncture site using both the CS catheter and the dilatator of the CB sheath. Thereafter access of the CB sheath to the left atrium could be achieved instantly and without further resistance. Conclusion: We report a safe and feasible maneuver to facilitate transseptal access with the CB steerable sheath in cases complicated by excessive interatrial resistance. (C) 2018 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Blockhaus, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Waibler, Hans-Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Guelker, Jan-Erik UNSPECIFIED UNSPECIFIED UNSPECIFIED Klues, Heinrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Bufe, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Shin, Dong-In UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-170545
DOI:	10.1016/j.jsha.2018.05.002
Journal or Publication Title:	J. Saudi Heart Assoc.
Volume:	30
Number:	4
Page Range:	S. 301 - 305
Date:	2018
Publisher:	ELSEVIER SCIENCE BV
Place of Publication:	AMSTERDAM
ISSN:	2212-5043
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ATRIAL-FIBRILLATION; ABLATION; ANATOMY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17054