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A 65-year-old man was admitted to our centre because of recurrent drug-resistant episodes of paroxysmal atrial fibrillation, for pulmonary vein radiofrequency catheter ablation. Double transseptal (TS) puncture was performed under real-time three-dimensional transoesophageal echocardiography (RT 3D TEE) guidance. We started by placing a quadripolar catheter in the coronary sinus and a Pigtail catheter in the aortic root as fluoroscopic landmarks. We then positioned the first 8 F TS sheath …

Double transseptal puncture guided by real-time three-dimensional transoesophageal echocardiography during atrial fibrillation ablation