Approach to the difficult transseptal: Diathermy facilitated left atrial access

Hany S. Abed, Muayad Alasady, Dennis H. Lau, Han S. Lim, Prashanthan Sanders

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Percutaneous transseptal left atrial (LA) access is increasingly becoming a routine procedure in the electrophysiology and cardiac catheterisation laboratories. Our aim was to review an unselected large series of this procedure performed over a period of five years. We clinically characterised difficult cases and presented a method of safe and expeditious LA access. Overall, 543 transseptal punctures were performed. Of those, 10 were classified as difficult, with failure to access the LA in three or more attempts. In all 10 cases, surgical electrocautery was successfully used to facilitate needle puncture of the septum. All patients subsequently underwent an uncomplicated procedure. In conclusion, we describe a method to trouble-shoot the difficult transseptal access procedure, outlining the clinical characteristics, echocardiographic features and special precautions that need to be considered when utilising this method.

Original languageEnglish
Pages (from-to)108-112
Number of pages5
JournalHeart Lung and Circulation
Issue number2
Publication statusPublished or Issued - Feb 2012


  • Body surface area
  • Left atrial access
  • Radiofrequency
  • Transseptal puncture

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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