Improved Left Atrial Catheterization Efficiency and Consistency using a
novel steerable transseptal puncture sheath
Abstract
Introduction: While steerable sheaths are widely used to
improve catheter stability and contact force during radiofrequency (RF)
catheter ablation in patients with atrial fibrillation (AF), steerable
sheaths are less commonly used during transseptal puncture. This study
evaluated whether left atrial catheterization efficiency can be improved
using the VersaCross combined steerable sheath and transseptal system
compared to previous standard workflow. Methods: This study
retrospectively analyzed AF ablation performed using the Versacross
Workflow consisting of VersaCross steerable sheath and RF wire for
transseptal puncture and catheter ablation (VCW) to the standard
workflow using a fixed curve sheath with RF needle followed by exchange
for an Agilis steerable sheath for catheter ablation (STW).
Results: Thirty patients underwent RF ablation for paroxysmal
or persistent AF, 15 using the VCW and 15 using the STW. Transseptal
puncture time was 10.8 mins faster with the VCW compared to the standard
workflow (20.9 ± 5.9 min vs. 31.7 ± 15.1 min; p=0.024). Time to left
atrial catheterization was 40% faster with the VCW compared to the STW
(21.3 ± 5.8 min vs. 35.2 ± 14.4 min; p=0.003). Overall procedure time
was 14.2 min faster in the VCW compared to the STW (86.3 ± 16.1 min vs.
100.5 ± 19.3 min; p=0.044). Conclusions: Use of the VersaCross
steerable system significantly reduced time to transseptal puncture,
time to left atrial catheterization, and overall RF ablation time.