Ablación de fibrilación auricular en paciente con dispositivo de oclusión septal interatrial

Renee Montesinos-Segura; Diego Davila-Flores; Fernando Quevedo-Candela; Mario Cabrera-Saldaña; Pío Zelaya-Castro; Richard Soto-Becerra

doi:10.47487/apcyccv.v4i2.288

Authors

Renee Montesinos-Segura Instituto Nacional Cardiovascular, INCOR-EsSalud, Lima, Perú. https://orcid.org/0000-0001-5426-830X
Diego Davila-Flores Instituto Nacional Cardiovascular, INCOR-EsSalud, Lima, Perú. https://orcid.org/0000-0001-5084-6547
Fernando Quevedo-Candela Instituto Nacional Cardiovascular, INCOR-EsSalud, Lima, Perú. https://orcid.org/0009-0009-5700-4372
Mario Cabrera-Saldaña Unidad de arritmias, Instituto Nacional Cardiovascular, INCOREsSalud, Lima, Perú. https://orcid.org/0000-0001-9802-1376
Pío Zelaya-Castro Unidad de arritmias, Instituto Nacional Cardiovascular, INCOREsSalud, Lima, Perú. https://orcid.org/0000-0003-4455-4905
Richard Soto-Becerra Unidad de arritmias, Instituto Nacional Cardiovascular, INCOREsSalud, Lima, Perú. https://orcid.org/0000-0003-3447-061X

DOI:

https://doi.org/10.47487/apcyccv.v4i2.288

Keywords:

Heart Septal Defects, Atrial, Septal Occluder Device, Atrial Fibrillation, Catheter ablation, Echocardiography

Abstract

Interatrial septal occlusion devices hinder the transseptal approach for atrial fibrillation ablation,
making it necessary to have imaging methods that safely guide transseptal puncture, such as intracardiac echocardiography (ICE). We describe the case of a 49-year-old patient with symptomatic paroxysmal atrial fibrillation, refractory to antiarrhythmic drugs, wearing an interatrial septal occlusion device, with a previous unsuccessful ablation attempt. Atrial fibrillation ablation was performed using the Carto V7 3D mapping system, the transseptal puncture was guided by ICE, and the procedure was successful. This case report highlights the importance of multimodality imaging to achieve successful and effective transseptal puncture for atrial fibrillation ablation in patients with interatrial septal occlusion devices.

Downloads

Download data is not yet available.

References

Hindricks G, Potpara T, Dagres N, Bax JJ, Boriani G, Dan GA, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021 Feb 1;42(5):373-498. doi: 10.1093/eurheartj/ehaa612.

Khairy P, van Hare GF, Balaji S, Berul CI, Cecchin F, Cohen MI, et al. PACES/HRS Expert Consensus Statement on the Recognition and Management of Arrhythmias in Adult Congenital Heart Disease. Heart Rhythm. Can J Cardiol. 2014 Oct;30(10):e1-e63. doi: 10.1016/j.cjca.2014.09.002.

Sang CH, Dong JZ, Long DY, Yu RH, Bai R, Salim M, et al. Transseptal puncture and catheter ablation of atrial fibrillation in patients with atrial septal occluder: Initial experience of a single centre. Europace. 2018 Sep 1;20(9):1468-74. doi: 10.1093/europace/eux282.

Garg J, Shah K, Turagam MK, Janagam P, Natale A, Lakkireddy D. Safety and efficacy of catheter ablation for atrial fibrillation

in patients with percutaneous atrial septal closure device: Electrophysiology Collaborative Consortium for Meta-analysis—ELECTRAM Investigators. J Cardiovasc Electrophysiol. 2020 Sep 1;31(9):2328-34. doi: 10.1111/jce.14616.

Alkhouli M, Rihal CS, Holmes DR. Transseptal Techniques for Emerging Structural Heart Interventions. JACC Cardiovasc Interv. 2016 Dec 26;9(24):2465-80. doi: 10.1016/j.jcin.2016.10.035.

Maclean E, Mahtani K, Roelas M, et al. Transseptal puncture for left atrial ablation: Risk factors for cardiac tamponade and a proposed causative classification system. J Cardiovasc Electrophysiol. 2022;33:1747–1755.

Saliba W, Thomas J. Intracardiac echocardiography during catheter ablation of atrial fibrillation. Europace. 2008 Nov;10 Suppl 3:iii42-7. doi: 10.1093/europace/eun233.