Ablation of atrial fibrillation in a patient with an interatrial septal occlusion device

Abstract

The interatrial septal occluder devices pose challenges for the transeptal approach in atrial fibrillation ablation, making it essential to have image-guided methods for safe transeptal puncture, such as intracardiac echocardiography (ICE). We describe the case of a 49-year-old patient with symptomatic paroxysmal atrial fibrillation, refractory to antiarrhythmic drugs, who had a previously unsuccessful ablation attempt and was carrying an interatrial septal occluder device. Atrial fibrillation ablation was performed using the Carto V7 3D mapping system, and the transseptal puncture was guided by ICE, resulting in a successful procedure. This case report highlights the importance of multimodality imaging to achieve successful and effective transeptal puncture for atrial fibrillation ablation in patients with interatrial septal occluder devices.