Transesophageal Echocardiographic Guidance of Transseptal Left Heart Catheterization During Radiofrequency Ablation of Left‐Sided Accessory Pathways in Humans

Tucker, Kelly J.; Curtis, Anne B.; Murphy, James D.; Conti, Jamie B.; Kazakis, D. James; Geiser, Edward A.; Conti, C. Richard

doi:10.1111/j.1540-8159.1996.tb03327.x

Cited by 59 publications

(20 citation statements)

References 15 publications

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“…Furthermore, transthoracic echocardiography is fairly uncomfortable to perform without a risk of violation of sterility during the intervention. TOE was found to be feasible, but cardiac perforation was reported because of inadequate localisation of the fossa ovalis 18. Furthermore, it carries the risk of oesophageal bleeding18 and limits communication with the patient during the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…TOE was found to be feasible, but cardiac perforation was reported because of inadequate localisation of the fossa ovalis 18. Furthermore, it carries the risk of oesophageal bleeding18 and limits communication with the patient during the procedure. TOE may cause lengthening of the procedure because of the introduction of the oesophageal probe and requires intravenous sedation for a longer period.…”

Section: Discussionmentioning

confidence: 99%

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Transseptal left heart catheterisation guided by intracardiac echocardiography

Szili-Török

Kimman

Theuns

et al. 2001

Heart

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Transseptal left heart catheterisation guided by intracardiac echocardiography

Szili-Török

Kimman

Theuns

et al. 2001

Heart

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“…[2][3][4][5] Because ICE provided information on not only the intracardiac structures but also the adjacent extracardiac structures, ICE could be used as the sole imaging modality and safety guide for transseptal catheterization. In fact, ICE-guided transseptal left heart catheterization for radiofrequency catheter ablation did not lead to complications in recent and present studies.…”

Section: Discussionmentioning

confidence: 99%

Shifting of Puncture Site in the Fossa Ovalis During Radiofrequency Catheter Ablation: Intracardiac Echocardiography-guided Transseptal Left Heart Catheterization

et al. 2003

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SUMMARYIntracardiac echocardiography (ICE) serves as an adjunct to fluoroscopy for electrophysiological procedures by identifying critical anatomic landmarks and confirming catheter-endocardial contact. In the present study, we investigated the usefulness of ICE for radiofrequency catheter ablation. ICE was utilized to guide transseptal puncture in 19 patients undergoing radiofrequency catheter ablation. The fossa ovalis, which was one critical anatomic landmark, had an average vertical diameter of 18.5 ± 6.9 mm and an average horizontal diameter of 10.0 ± 2.4 mm, as measured by ICE and fluoroscopy. Although there was only a small shift of the puncture site in the horizontal direction, the puncture site shifted towards the upper edge of the fossa ovalis for 17 patients (89%). Furthermore, we could verify that the distance between the apex of the tent-shape formed by the pressure of the puncture needle in the fossa ovalis and the left atrial wall opposing it was sufficient to carry out the procedure safely. Confirming the puncture site using ICE is useful in carrying out transseptal left heart catheterization safely. (Jpn Heart J 2003; 44: 673-680) Key words: Intracardiac echocardiography, Fossa ovalis, Transseptal catheterization OVER the past few years, atrial septal puncture through the fossa ovalis has become important for radiofrequency catheter ablation in many patients with leftsided accessory pathway and atrial fibrillation.1-3) This procedure has been performed under transthoracic ultrasound and/or right atrial contrast radiography guidance. However, the complication rate for this procedure was reported to be 2% to 6%.2-5) The major reason for this is our inability to identify the fossa ovalis. Recently, the utility of intracardiac echocardiography (ICE) in clearly visualizing

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“…ICE is particularly useful for guiding transseptal puncture during mapping and ablation procedures for left-sided accessory pathways [11,64]. It can locate the needle tip position precisely and provides clear visualization of the ''tenting effect'' on the fossa ovalis.…”

Section: Echocardiography Guided Catheter Ablationmentioning

confidence: 99%

The use of echocardiography in Wolff–Parkinson–White syndrome

Cai

Shuraih

Nagueh

2011

Int J Cardiovasc Imaging

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Endocardial mapping and radiofrequency catheter ablation are well established modalities for the diagnosis and treatment of patients with Wolff-Parkinson-White (WPW) syndrome associated with tachyarrhythmias. However, the electrophysiologic techniques are invasive, require radiation exposure, and lack spatial resolution of cardiac structures. A variety of echocardiographic techniques have been investigated as a non-invasive alternative for accessory pathway localization. Conventional M-mode echocardiography can detect the fine premature wall motion abnormalities associated with WPW syndrome. However, it is unable to identify the exact site of accessory pathway with sufficient accuracy. 2D, 2D-guided M-mode, and 2D phase analysis techniques are limited by image quality and endocardial border definition. Various modalities of tissue Doppler echocardiography significantly increase the accuracy of left-sided accessory pathway localization to 80-90% even in patients with poor acoustic window. However, right-sided pathways remain a diagnostic challenge. Strain echocardiography by speckle tracking has recently been evaluated and appears promising. Different cardiac abnormalities have been detected by echocardiography in WPW patients. Patients with WPW syndrome and tachyarrhythmias have impaired systolic and diastolic function which improves after radiofrequency ablation. Echocardiography is useful in identifying patient with accessory pathway-associated left ventricular dyssynchrony and dysfunction who may benefit from ablation therapy. Transesophageal and intracardiac echocardiography have been used to guide ablation procedure. Ablation-related complications detected by routine echocardiography are infrequent, rarely clinically relevant, and of limited value.

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Transesophageal Echocardiographic Guidance of Transseptal Left Heart Catheterization During Radiofrequency Ablation of Left‐Sided Accessory Pathways in Humans

Cited by 59 publications

References 15 publications

Transseptal left heart catheterisation guided by intracardiac echocardiography

Transseptal left heart catheterisation guided by intracardiac echocardiography

Shifting of Puncture Site in the Fossa Ovalis During Radiofrequency Catheter Ablation: Intracardiac Echocardiography-guided Transseptal Left Heart Catheterization

The use of echocardiography in Wolff–Parkinson–White syndrome

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