TY - JOUR
T1 - Surgical electrocautery facilitated transseptal puncture in children
AU - Elayi, Claude Samy
AU - Gurley, John Carl
AU - Di Sessa, Thomas Gerald
AU - Kakavand, Bahram
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2011/7
Y1 - 2011/7
N2 - Background: Transseptal puncture has been performed in adults and children for decades. However, transseptal puncture can be challenging especially in pediatric patients because of an elastic septum and small atria. In adults, dedicated radiofrequency (RF) to facilitate transseptal puncture has become routine. Objectives: We wanted to assess whether RF could be used routinely in children to facilitate transseptal procedure. Method: The study population included all children referred to our electrophysiology lab who underwent an ablation requiring a transseptal puncture over a period of 10 months. RF was applied at the time of transseptal puncture. The source of RF was standard surgical electrocautery device with the electrosurgical pen in direct contact with the transseptal needle applied for a short period of time during transseptal puncture. RF output was set initially at 30 W in cut mode. All procedures were performed under general anesthesia. Patients were followed for possible complications. Results: Thirteen patients (ages 11.6 ± 3.6 years, range 5-17 years, five boys) were included. One patient had left ventricular tachycardia, and the remainder had a supraventricular tachycardia with a left-sided accessory pathway. In all but two patients, a single attempt with an RF output of 30 W applied for less than 2 seconds was sufficient to cross the septum. In two patients, three attempts were needed with a last successful attempt using 35 W. No complications were observed either acutely or during the follow-up. Conclusion: Transseptal puncture facilitated by RF energy can be performed in children routinely and safely.
AB - Background: Transseptal puncture has been performed in adults and children for decades. However, transseptal puncture can be challenging especially in pediatric patients because of an elastic septum and small atria. In adults, dedicated radiofrequency (RF) to facilitate transseptal puncture has become routine. Objectives: We wanted to assess whether RF could be used routinely in children to facilitate transseptal procedure. Method: The study population included all children referred to our electrophysiology lab who underwent an ablation requiring a transseptal puncture over a period of 10 months. RF was applied at the time of transseptal puncture. The source of RF was standard surgical electrocautery device with the electrosurgical pen in direct contact with the transseptal needle applied for a short period of time during transseptal puncture. RF output was set initially at 30 W in cut mode. All procedures were performed under general anesthesia. Patients were followed for possible complications. Results: Thirteen patients (ages 11.6 ± 3.6 years, range 5-17 years, five boys) were included. One patient had left ventricular tachycardia, and the remainder had a supraventricular tachycardia with a left-sided accessory pathway. In all but two patients, a single attempt with an RF output of 30 W applied for less than 2 seconds was sufficient to cross the septum. In two patients, three attempts were needed with a last successful attempt using 35 W. No complications were observed either acutely or during the follow-up. Conclusion: Transseptal puncture facilitated by RF energy can be performed in children routinely and safely.
KW - Left-sided accessory pathways
KW - Radiofrequency ablation
KW - Supraventricular tachycardia
KW - Transseptal puncture
UR - http://www.scopus.com/inward/record.url?scp=84860417811&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84860417811&partnerID=8YFLogxK
U2 - 10.1111/j.1540-8159.2011.03056.x
DO - 10.1111/j.1540-8159.2011.03056.x
M3 - Article
C2 - 21410731
AN - SCOPUS:84860417811
SN - 0147-8389
VL - 34
SP - 827
EP - 831
JO - PACE - Pacing and Clinical Electrophysiology
JF - PACE - Pacing and Clinical Electrophysiology
IS - 7
ER -