A Comparison of Two Different Transseptal Puncture Strategies Without Fluoroscopy Guidance
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 28
- Locations
- 1
- Primary Endpoint
- Total TSP time
Study Overview
Brief Summary
Zero-fluoroscopy is the dream of all interventionists, and as low as reasonably achievable (ALARA) is the goal the investigators can manage at this moment. Trans-septal puncture (TSP) is the most pivotal step in the ablation procedure for left heart procedure, including atrial fibrillation ablation, and it is the only step that still needs fluoroscopy in the era of 3D electroanatomical map. With the incorporation of intracardiac echocardiography (ICE), the dream of zerofluoroscopy can be achieved.
Because the imaging offered by fluoroscopy or ICE is so different in terms of the advantages and shortages, the best TSP protocols might be different. Currently, in the literature, two techniques are commonly referred. However, no comparison has been made between these two techniques. Therefore, this study is to compare the safety and efficiency of these two techniques, also to observe the transition of a senior EP doctor who has been experienced in fluoroscopy-guided TSP, hoping to establish the learning curve for future reference of zerofluoroscopy promotion.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients with paroxysmal or persistent AF and are scheduled to undergo at least but not limited to pulmonary vein (PV) isolation.
- •Patients who are willing to sign the informed consent.
Exclusion Criteria
- •The patients need right atrial mapping and/or ablation before TSP.
- •The women who is pregnant.
- •Informed consent could not be obtained.
Arms & Interventions
Echocardiography
The movement of the puncture needle was monitored using intracardiac echocardiography rather than fluoroscopy. All other steps followed the conventional approach.
Intervention: J Wire (Procedure)
3D mapping system
Guided by the ablation catheter image on the 3D mapping system, the long sheath was advanced to the puncture site and then exchanged for a puncture needle. The entire procedure was monitored with intracardiac echocardiography.
Intervention: 3D mapping system (Procedure)
Outcomes
Primary Outcomes
Total TSP time
Time Frame: Perioperative
Time duration from femoral venous access to the completion of both the first and second transseptal puncture (TSP). Unit of Measure: Minutes
Fluoroscopy usage and radiation dose
Time Frame: during the procedure
Whether fluoroscopy was used during the procedure and the corresponding radiation dose recorded if applicable.
Incidence of procedural complications
Time Frame: up to 12 weeks
Occurrence of major complications during the procedure, including pericardial effusion, cardiac tamponade, stroke, or death.
Secondary Outcomes
No secondary outcomes reported