Patient population
In this retrospective study we included 524 consecutive adult and
pediatric patients who were referred to our institution from July 2014
to December 2019 requiring TSP for CA of left-sided arrhythmias.
Fluoroless approach in our center was gradually implemented for
different CA procedures. Consequently, patients with left-sided
tachycardias were included in this retrospective study at different
points in time with consecutive TSPs thereafter: left-sided
supra-ventricular tachycardias (SVTs) since July 2014, AF since March
2015 and left-sided VT since March 2017.
Left sided focal atrial tachycardia (AT), left-sided accessory pathway
(AP) mediated tachycardia, atrioventricular nodal reentry tachycardia
(AVNRT), or left-sided VT typically received single transseptal access.
Patients with AF and left-sided atypical atrial flutters typically
received double TSPs, except patients undergoing hybrid (combined
surgical and catheter ablation) procedure for AF which received single
transseptal access. Typically, the radio-frequency (RF) needle technique
was used in difficult TSP cases. Pediatric patients and patients with
CIEDs were also included. Each CIED was tested for proper function
before and after the procedure to ensure no change in pacing and sensing
parameters occurred. Lead visualization during procedures was entirely
performed with ICE without fluoroscopy.