Transseptal Puncture Guided by Transesophageal Echocardiography without Fluoroscopy during Catheter Ablation of Left-Sided Accessory Pathways in Children

Background: Transseptal puncture (TSP) is a routine procedure to access the left atrium for catheter ablation of left-sided arrhythmia. However, it is still challenging in children due to not only small body, more septal flexibility and unsuitable equipment but also the long-term carcinogenic effect of X-ray. The aim of this study was to present the efficacy and safety of transseptal puncture with the help of a transesophageal echocardiography (TEE) and 3D electro-anatomical mapping systems (3D-EAM) without X-ray during the catheter ablation of left-sided accessory pathways (APs) in children.