Key result
Superior venous approach via atrial septoplasty enables catheter ablation for persistent AF despite IVC obstruction.
Why the study?
Inferior vena cava obstruction can make the traditional inferior transfemoral venous approach for transseptal puncture and left atrial access impossible.
Describes a novel superior approach using atrial septoplasty for atrial fibrillation ablation in a patient with inferior vena cava obstruction.
Should not change practice in IVC obstruction; leaves open need for validation in larger cohorts.
Catheter ablation is widely used in treating atrial fibrillation (AF) and other tachyarrhythmias originating from the left atrium (LA).1,2 Transseptal puncture to access the LA has traditionally been performed via the inferior transfemoral venous approach. Inferior vena cava (IVC) obstruction, either congenital or acquired, is a rare condition that can make inferior access impossible.3
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Kontogiannis et al. (2024) studied this question. A superior venous approach facilitated by atrial septoplasty enabled catheter ablation for persistent atrial fibrillation in a patient with inferior vena cava obstruction.
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