Open AccessTransseptal puncture through the atrial septal occluder in patient with atrial fibrillation for guided radiofrequency ablation procedure using remote magnetic navigation: A clinical case
Author(s) -
Andrey Ponomarenko,
N. A. Yelemessov,
Ю. С. Перегудов,
Р. Э. Жижов,
Věra Baranová,
Euan Fisher,
В. В. Шабанов,
Alexander Chernyavskiy,
А. Б. Романов
Publication year - 2021
Publication title -
patologiâ krovoobraŝeniâ i kardiohirurgiâ/patologiâ krovoobrašeniâ i kardiohirurgiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.136
H-Index - 3
eISSN - 2500-3119
pISSN - 1681-3472
DOI - 10.21688/1681-3472-2021-1-114-119
Subject(s) - medicine , atrial fibrillation , interatrial septum , cardiology , pulmonary vein , ablation , radiofrequency ablation , catheter ablation , sinus rhythm , surgery , left atrium
Access to the left atrium during transseptal puncture for radiofrequency ablation in patients with atrial fibrillation (AF) and implanted atrial septal occluder can be challenging. This is particularly true when the occluder covers the entire septum and there is no ideal puncture site. This might lead to potential difficulties in arrhythmia treatment. A 59-year-old patient with drug refractory AF, a dilated left atrium, and an implanted atrial septal occluder underwent double transseptal puncture through atrial septal occluder with subsequent pulmonary vein isolation using remote magnetic navigation. The effectiveness of the manipulation was confirmed by intraoperative stimulation from the Lasso catheter and by Holter monitoring data post-operation. It was revealed that the patient had sinus rhythm and no complications occurred. There were no shunts at the occluder level on transthoracic echocardiography, and there were no atrial tachyarrhythmias during the nine-month follow up period without antiarrhythmic drugs. The presented clinical case demonstrates the safety and efficacy of transseptal puncture through an implanted occluder in the interatrial septum to perform re-ablation using robotic magnetic navigation in a patient with AF. Received 21 October 2020. Revised 20 November 2020. Accepted 25 November 2020. Funding: The work is supported by a grant of the President of the Russian Federation No. МД-1997.2020.7. Conflict of interest: Authors declare no conflict of interest. Author contributions Drafting the article: А.V. Ponomarenko, R.E. Zhizhov, V.V. Baranova, E.V. Fisher, A.B. Romanov Literature review: А.V. Ponomarenko, R.E. Zhizhov, V.V. Baranova, E.V. Fisher Illustrations: А.V. Ponomarenko, A.B. Romanov Critical revision of the article: А.V. Ponomarenko, R.E. Zhizhov, V.V. Baranova, A.M. Chernyavskiy, A.B. Romanov Surgical treatment: N.А. Yelemessov, I.S. Peregudov, V.V. Shabanov, A.B. Romanov Final approval of the version to be published: А.V. Ponomarenko, N.А. Yelemessov, I.S. Peregudov, R.E. Zhizhov, V.V. Baranova, E.V. Fisher, V.V. Shabanov, A.M. Chernyavskiy, A.B. Romanov