%0 Journal Article
%T Intracardiac echocardiography to guide transseptal catheterization for radiofrequency catheter ablation of left-sided accessory pathways: two case reports
%A Rodolfo Citro
%A Valentino Ducceschi
%A Alessandro Salustri
%A Michele Santoro
%A Michele Salierno
%A Giovanni Gregorio
%J Cardiovascular Ultrasound
%D 2004
%I BioMed Central
%R 10.1186/1476-7120-2-20
%X Trans-catheter radiofrequency ablation (TCRFA) has become the treatment of choice for patients suffering from refractory to medical treatment supraventricular tachycardias [1,2]. During percutaneous ablation procedures, catheter location is usually monitored by using fluoroscopy together with the analysis of intracardiac electrograms in order to clarify the mechanisms underlining the arrhythmia and to both locate its origin and record its circuit. This technique may be adequate for several standard ablative procedures, but it has still some limitations concerning the treatment of more complex tachycardia forms.Left-sided accessory pathway (LSAP) may be ablated using two different modalities: conventional approach through the aortic valve, or transseptal puncture of the fossa ovalis. By using the traditional approach, the left atrium is reached by a retrograde way through the left ventricle and crossing the mitral valve [3,4] whereas, with the transseptal puncture, the mitral ring is reached by an anterograde approach. For this reason, this approach has been considered an alternative and complementary technique for the transvenous introduction of catheters into the left cavities of the heart [5-8]. However, transseptal puncture under fluoroscopic guidance alone, might be hampered by some acute and potentially lethal complications that may be challenging even for expert electrophysiologists [9].With the technological and miniaturization advances of low frequency transducers capable of enhanced tissue penetration, intracardiac echocardiography (ICE) has become feasible and potentially useful for guiding transseptal puncture and ablation procedures, especially when location of specific anatomic landmarks appears to be more crucial [10,11].In this manuscript, two cases of ICE-guided catheter ablation of LSAP via transseptal approach have been described.A 24 year-old woman with Wolf-Parkinson-White (WPW) syndrome and recurrent episodes of sustained supraventricular tachyc
%U http://www.cardiovascularultrasound.com/content/2/1/20