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First experience with left atrial arrhythmia ablation using a bidirectional steerable transseptal sheath (Vizigo) visible in the CARTO system as a method to reduce fluoroscopy

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Koźluk E., Łojewska K., Hiczkiewicz J.

European Journal of Translational and Clinical Medicine

2020

vol. 3

issue 2

18-21

In this report we present ablations of complex left atrial arrhythmias in 3 male patients using the bi-directional steerable transseptal sheath (Visigo) which is visualizable by the 3D electro-anatomical system. Ablations of complex left atrial (LA) arrhythmias were performed in 3 patients. In the first 2 patients typical transseptal punctures were performed, followed by mapping with the LassoNav catheter and PVI (one patient also had isolation of the posterior segment). The last patient had a residual atrial septal leak, therefore ablation without fluoroscopy was attempted. An anatomical map of the right atrium was made. The ablation catheter and the Vizigo sheath were introduced into the LA through the leak in the septum. LA, pulmonary veins and 3 tachycardia loops were mapped. Lines were made in the roof of LA, in the mitral isthmus and within the atrial septum, restoring the sinus rhythm. Times of procedures/fluoroscopy were: 185, 185, 205min / 5.5; 3.8 and 0min. In the group of the last 10 previous ablations, these times were respectively: 209±48min/5,6±1,8 min. We conclude that the Vizigo sheath reduces the risk of electrode and sheath dislocation into the right atrium and the need for fluoroscopic verification during maneuvers performed with the sheath. It is also a step towards simpler left atrial ablation without the use of fluoroscopy.

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1 European Journal of Translational and Clinical Medicine

1 2020

1 Hiczkiewicz J.

1 Koźluk E.

1 Łojewska K.

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First experience with left atrial arrhythmia ablation using a bidirectional steerable transseptal sheath (Vizigo) visible in the CARTO system as a method to reduce fluoroscopy