Incidence of tissue coring during transseptal catheterization when using electrocautery and a standard transseptal needle

Circulation. Arrhythmia and Electrophysiology
Eugene GreensteinBradley P Knight

Abstract

The application of radiofrequency electrocautery to a standard, open-ended transseptal needle has been used to facilitate transseptal puncture (TSP). The purpose of this study was to determine the incidence of cardiac tissue coring when this technique is used. A model using excised swine hearts submerged in a saline-filled basin was developed to simulate TSP with electrocautery and a standard transseptal needle. Punctures were performed without the use of electrocautery and by delivering radiofrequency energy to the transseptal needle using a standard electrocautery pen at 3 target sites (fossa ovalis, non-fossa ovalis septum, and aorta). The tissue of the submerged heart was gently tented, and the needle was advanced on delivery of radiofrequency. The devices were retracted, and the needle was flushed in a collection basin. None of the TSPs without cautery caused tissue coring. For TSPs using electrocautery, the frequency of coring was at least 21% for any puncture permutation used in the study and averaged 37% at septal sites (P<0.001 compared with punctures without cautery). Tissue coring occurred in 33 of 96 (35%) punctures through the fossa ovalis and in 38 of 96 (40%) punctures through non-fossa ovalis septum. The frequen...Continue Reading

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Citations

Jan 5, 2014·Pacing and Clinical Electrophysiology : PACE·Faisal M Merchant, David B Delurgio
May 25, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Gaurav SharmaJason H Rogers
Sep 25, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Jaffar M KhanAdam B Greenbaum
Aug 3, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Srinath T GowdaHarinder R Singh
Dec 25, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Gaël JauvertArnaud Lazarus
Oct 28, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Anthony W C ChowJames W McCready
Mar 3, 2017·BioMed Research International·Vikas KatariaMattias Duytschaever
Apr 17, 2020·Journal of Cardiovascular Electrophysiology·José M SanchezGregory M Marcus
Jan 18, 2021·Pediatric Cardiology·Matthias J MüllerThomas Paul
Jul 19, 2020·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Tara L JonesAnwar Tandar
Jan 4, 2022·Journal of Cardiovascular Electrophysiology·Jeremiah Wasserlauf, Bradley P Knight

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