Safety and feasibility of fluoroscopy-guided transseptal puncture during cryoballoon ablation for paroxysmal atrial fibrillation: A single-center descriptive study
Nội dung chính của bài viết
Tóm tắt
Cryoballoon pulmonary vein isolation (PVI) is an established rhythm-control strategy for atrial fibrillation (AF), with transseptal puncture (TSP) typically guided by transesophageal or intracardiac echocardiography to optimize safety and accuracy. However, in resource-constrained settings, transseptal puncture is frequently performed using fluoroscopic guidance alone, despite the limited evidence regarding its safety and efficacy. This study evaluated the procedure-related safety and efficacy of fluoroscopy-guided TSP in 24 patients with paroxysmal AF undergoing first-time cryoballoon ablation at the Vietnam National Heart Institute, Bach Mai Hospital between November 2023 and August 2025. All TSP procedures were successfully completed without complications. The mean number of needle attempts was 3.2 ± 1.5, mean fluoroscopy time was 9.2 ± 1.8 minutes, and mean TSP time was 12.0 ± 2.5 minutes. A total of 100 pulmonary veins were acutely isolated; Except for two right inferior pulmonary veins with suboptimal occlusion, which were successfully isolated using the pull-down maneuver, all remaining veins achieved optimal occlusion. At 6-month follow-up, AF recurrence occurred in one patient (4.2%), with a marked reduction in AF burden. Fluoroscopy-guided transseptal puncture alone during cryoballoon ablation for atrial fibrillation appears feasible, with high acute procedural success, a favorable 6-month atrial fibrillation recurrence rate, and no observed TSP-related complications in this preliminary cohort.
Chi tiết bài viết
Từ khóa
Atrial fibrillation; Cryoballoon ablation; Transseptal puncture
Tài liệu tham khảo
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