Key result
A superior approach using steerable sheaths, radiofrequency wires, and intracardiac echocardiography enables left atrial catheterization and ablation of atrial fibrillation when transfemoral access is impossible.
Why the study?
In patients requiring catheter ablation of AF who have inferior vena cava interruption, standard transfemoral venous access is not possible.
Provides a technical guide for performing left atrial transseptal access and AF ablation via a superior venous approach in patients with inferior vena cava interruption.
Answers are grounded in this paper and cite their sources.
May enable AF ablation when femoral access fails; hypothesis-generating and requires prospective validation.
The standard technique for percutaneous catheter ablation of atrial fibrillation (AF) involves obtaining left atrial access and catheter manipulation from an inferior transfemoral venous access. However, in patients with inferior vena cava interruption, a standard transfemoral venous approach is not possible. In these cases, a percutaneous approach from a superior central vein, such as the internal jugular vein or the axillary/subclavian vein can be considered. In this article, we describe the details of our technique to obtain left atrial catheterization and perform catheter ablation of AF from a superior approach. Our technique involves the use of steerable sheaths, dedicated radiofrequency wires, and intracardiac echocardiography guidance.
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Santangeli et al. (2019) studied Atrial fibrillation. Left atrial transseptal access and catheter ablation from a superior approach was evaluated. A superior approach using steerable sheaths, radiofrequency wires, and intracardiac echocardiography enables left atrial catheterization and ablation of atrial fibrillation when transfemoral access is impossible.
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