scholarly journals Transseptal Access: A Review of Contemporary Tools

2022 ◽  
Author(s):  
Rachel Kaplan ◽  
Jeremiah Wasserlauf ◽  
Bradley Knight
Keyword(s):  
Left Atrial ◽  
Transseptal Catheterization ◽  
Difficult Cases

Transseptal left atrial catheterization is routinely used for many common catheter-based interventions. Tools for transseptal catheterization have advanced over the recent years. Such tools include imaging advances with intracardiac echocardiology as well as an array of needles, wires, and dilators to achieve transseptal access with greater ease and safety. This review will discuss the contemporary tools for transseptal catheterization and guidance for difficult cases.

Left atrial and ventricular transseptal catheterization review: Losing skills?

1987 ◽  
Vol 13 (4) ◽  
pp. 233-238 ◽  
Author(s):  
Fred W. Schoonmaker ◽  
Nampalli K. Vijay ◽  
Richard D. Jantz
Keyword(s):  
Left Atrial ◽  
Transseptal Catheterization

scholarly journals First-in-Human Use of a Novel 4D Intracardiac Echocardiography Catheter To Guide Interventional Electrophysiology Procedures

2021 ◽  
Author(s):  
Rachel Kaplan ◽  
Akhil Narang ◽  
Hawkins Gay ◽  
Xu Gao ◽  
Mohammed Gibreal ◽  
...  
Keyword(s):  
Real Time ◽  
Pulmonary Vein ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Intracardiac Echocardiography ◽  
Left Atrial Appendage Closure ◽  
High Quality ◽  
Interventional Electrophysiology ◽  
Transseptal Catheterization ◽  
2D And 3D

Introduction: Standard two-dimensional (2D), phased-array intracardiac echocardiography (ICE) is routinely used to guide interventional electrophysiology (EP) procedures. A novel four-dimensional (4D) ICE catheter (VeriSight Pro®, Philips, Andover, MA) can obtain 2D and three-dimensional (3D) volumetric images and cine-videos in real time (4D). The purpose of this study was to determine the early feasibility and safety of this 4D ICE catheter during EP procedures. Methods: The 4D ICE catheter was placed from the femoral vein in ten patients into various cardiac chambers to guide EP procedures requiring transseptal catheterization, including ablation for atrial fibrillation and left atrial appendage closure. 2D- and 3D- ICE images were acquired in real time by the electrophysiologist. A dedicated imaging expert performed digital steering to optimize and post-process 4D images. Results: Eight patients underwent pulmonary vein isolation (cryoballoon in 7 patients, pulsed field ablation in 1, additional radiofrequency left atrial ablation in 1). Two patients underwent left atrial appendage closure. High quality images of cardiac structures, transseptal catheterization equipment, guide sheaths, ablation tools, and closure devices were acquired with the ICE catheter tip positioned in the right atrium, left atrium, pulmonary vein, coronary sinus, right ventricle, and pulmonary artery. There were no complications. Conclusion: This is the first-in-human experience of a novel deflectable 4D ICE catheter used to guide EP procedures. 4D ICE imaging in safe and allows for acquisition of high-quality 2D and 3D images in real-time. Further use of 4D ICE will be needed to determine its added value for each EP procedure type.

Modified Earpieces and CROS for High Frequency Hearing Losses

1968 ◽  
Vol 11 (1) ◽  
pp. 204-218 ◽  
Author(s):  
Elizabeth Dodds ◽  
Earl Harford
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Sound Field ◽  
Intensity Level ◽  
Test Results ◽  
High Frequency Hearing Loss ◽  
Increased Sensitivity ◽  
Difficult Cases

Persons with a high frequency hearing loss are difficult cases for whom to find suitable amplification. We have experienced some success with this problem in our Hearing Clinics using a specially designed earmold with a hearing aid. Thirty-five cases with high frequency hearing losses were selected from our clinical files for analysis of test results using standard, vented, and open earpieces. A statistical analysis of test results revealed that PB scores in sound field, using an average conversational intensity level (70 dB SPL), were enhanced when utilizing any one of the three earmolds. This result was due undoubtedly to increased sensitivity provided by the hearing aid. Only the open earmold used with a CROS hearing aid resulted in a significant improvement in discrimination when compared with the group’s unaided PB score under earphones or when comparing inter-earmold scores. These findings suggest that the inclusion of the open earmold with a CROS aid in the audiologist’s armamentarium should increase his flexibility in selecting hearing aids for persons with a high frequency hearing loss.

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