Modified Ablation Catheter Guided Transseptal Puncture under ICE Guidance

Abstract Background Zero-fluoroscopy procedures have become increasingly popular in electrophysiological interventional surgery. As the key technology to achieve zero-fluoroscopy, traditional transseptal puncture (TSP) under ICE guidance has some disadvantages, which limit its promotion and development. We aim to introduce, evaluate the efficiency and safety of a modified TSP technique distilled from practice with the potential to overcome the shortcomings of traditional TSP. Methods A total of 77 patients underwent atrial fibrillation radiofrequency ablation from March 1,2022 to February 28, 2023 were enrolled. 44 patients underwent traditional ICE guided transseptal puncture and 33 patients underwent advanced ICE guided transseptal puncture. Then success rate, attempts of puncture, puncture duration, proportion of ideal puncture location and incidence of puncture related complications were recorded subsequently. Results There were no significant differences in baseline data between the two groups. The number of puncture times (1.25 ± 0.44 vs.1.06 ± 0.24, p = 0.018) and puncture duration (2.52 ± 0.83 vs.3.94 ± 2.15, p = 0.001) of advanced method were significantly less than traditional method. There were no significant differences in the success rate of puncture, the proportion of ideal puncture location and the incidence of puncture related complications between the two groups. Conclusions This study presents a modified ablation catheter guided transseptal puncture under ICE guidance, which simplifies the operation of the puncture component and does not require ICE view tracking. This method has the advantages of high success rate, safety, simple steps, convenient use, and short learning curve, and is worthy of promotion and application.