Inferior approach instead of standard “pull-down” technique for transseptal puncture in difficult anatomy

Abstract

A 71-year-old male with kyphoscoliosis (Fig. 1a), persistent atrial fibrillation recurrent to amiodarone, LVEF 35%, and suspicious of tachycardiomyopathy was admitted for pulmonary veins isolation. An Agilis NxT Steerable introducer (St Jude Medical, Minnetonka, MN, USA) and an intracardiac echo (ICE) probe were advanced into the superior vena cava and right atrium, respectively.

Un hombre de 71 años con cifoescoliosis (Fig. 1a), fibrilación auricular persistente recurrente a amiodarona, FEVI del 35% y sospecha de taquicardiomiopatía fue ingresado para aislamiento de venas pulmonares. Un introductor orientable Agilis NxT (St Jude Medical, Minnetonka, MN, EE. UU.) y se hizo avanzar una sonda de eco intracardíaco (ICE) hacia la vena cava superior y la aurícula derecha.