Use of an Angioplasty Wire to Perforate the Interatrial Septum for a Difficult Transseptal Puncture

With the expansion in catheter‐based treatments for atrial fibrillation the number of transseptal punctures being performed by cardiac electrophysiologists has increased significantly. Although in general transseptal puncture is successful, in a small percentage of cases it cannot be achieved due to complex intraatrial anatomy. We report the case of a difficult transseptal puncture (TSP), performed where the conventional approach using a Brockenbrough needle sheath was unable to perforate the septum. TSP was only achieved using a novel technique assisted by an angioplasty wire. (PACE 2010; 33:243–245)