Comparison of a Radiofrequency Powered Flexible Needle with a Classic Rigid Brockenbrough Needle for Transseptal Punctures in Terms of Safety and Efficacy

TCT-703 Accuracy and Procedural Characteristics of Radiofrequency Compared With Standard Needle Transseptal Puncture for Structural Heart Interventions

“…They also achieved shorter time to TS puncture (27.1 AE 10.9 vs. 36.5 AE 17.7 min, P < 0.001) with a RF needle with lower failure rates of TS crossing (0.17% vs. 1.23%, P ¼ 0.039) and fewer complications as compared to the standard needle (0 vs. 9 pericardial tamponade, P ¼ 0.31) [9]. Jauvert et al were the first to demonstrate that a flexible RF needle is also more efficient (success in 125 of 125 RF vs. 95 of 100 standard needles, P ¼ 0.01) and safer than a standard needle (3 vs. 0 pericardial effusions, P ¼ 0.04) [13]. Recently, in the first randomized 1:1 control trial of 72 patients, Hsu et al prospectively confirmed that RF needle results in shorter procedural times (2.3 vs. 7.3 min, P ¼ 0.005) with less failure to achieve TS puncture (0% vs. 27.8%, P < 0.001) [12].…”

“…In 2001, Justino et al first described using radiofrequency energy as an alternative approach to TS [6]. Obviating the need for excessive mechanical force, radiofrequency (RF) needle TS puncture offers the ability to safely overcome some of the aforementioned drawbacks of the standard needle approach with reduced procedural and fluoroscopy times [5,[8][9][10][11][12][13]. Given that less mechanical pushing force may be required to cross with RF energy, it has been hypothesized that this would result in less "sliding" of the needle during crossing and therefore improved spatial accuracy related to the intended puncture site.…”

A Novel Toolkit to Improve Percutaneous Subxiphoid Needle Access to the Healthy Pericardial Sac

“…This is akin to benefits derived from facilitation of atrial transseptal puncture. 9 Although not observed in the present study, risks of this technique would include accentuated damage to epicardial structures. It is our impression that the parietal pericardium of healthy young pigs is typically thicker and tougher, and thus more resistant to perforation than in man.…”

“…In theory, facilitation would improve puncture site selectivity and reduce risk associated with pushing of the needle. This is akin to benefits derived from facilitation of atrial transseptal puncture . Although not observed in the present study, risks of this technique would include accentuated damage to epicardial structures.…”

Off the pedal: Fluoroless transseptal puncture in pediatric supraventricular tachycardia ablation

“…McWilliams and Tchou reported early use of radiofrequency energy to cross the atrial septum by applying a unipolar Bovi cautery pen to a Brockenbrough needle 11. Multiple authors have utilized the radiofrequency-powered needle (Baylis Medical, Montreal, Canada) for TS puncture and demonstrated 100% success, faster procedure times compared to Brockenbrough needle, and no adverse events 12,13. Our fluoroless TS procedure had shorter times compared to those performed with the Brockenbrough needle, but these did not reach statistical significance and may have been confounded by the use of the radiofrequency needle.…”