Zero‑exchange approach using a steerable FlexCath Advance sheath for direct transseptal access in cryoballoon ablation for pulmonary vein isolation – case study

Abstract

Transseptal puncture during pulmonary vein isolation for atrial fibrillation is one of the crucial elements of the procedure. The usual two-step approach requires using a fixed-curve transseptal sheath for the puncture and then exchanging it for the steerable sheath, which can be associated with a potential risk of aspirating air into the system or losing left atrial access. We present a case study of a female patient in whom left atrial access was successfully achieved by direct transseptal puncture using the steerable FlexCath sheath, avoiding the potential risks of sheath exchange.