TRANS-SEPTAL CATHETERIZATION FOR RADIOFREQUENCY CATHETER ABLATION OF CARDIAC-ARRHYTHMIAS - RESULTS AND SAFETY OF A SIMPLIFIED METHOD

Aim This study reports on the results and safety of a simplified metho d of trans-septal catheterization for radio-frequency catheter ablatio n of cardiac arrhythmias. Method and Results Over 5 years, 411 patient s underwent trans-septal catheterization for radiofrequency catheter a blation: 388 patients had a left-sided accessory pathway, 19 a left-si ded focal atrial tachycardia, two atrial fibrillation and two post-inf arction ventricular tachycardia. All but one patient with ventricular tachycardia underwent elective trans-septal catheterization. In the ab sence of a patent foramen ovale, puncture of the atrial septum was per formed by using an 8F Mullins sheath and a Brockenbrough needle, accor ding to the simplified method described in this paper. Trans-septal ca theterization was accomplished in 383/388 patients (98.7%); in 41 pati ents a second trans-septal catheterization and radiofrequency catheter ablation was performed for initial failure or recurrence. Radiofreque ncy catheter ablation was successful in 96% of accessory pathway patie nts, 90% of atrial tachycardia patients, in both patients with atrial fibrillation and in both patients with ventricular tachycardia. No com plication related to trans-septal catheterization was observed. Conclu sion In experienced hands and according to the method described in thi s paper, the elective use of transseptal catheterization for radiofreq uency catheter ablation in a large cohort of patients with cardiac arr hythmias is feasible, safe and allows successful ablation in the vast majority of the patients.