Introduction
Transseptal puncture (TSP) is the crucial step in a variety of cardiac
procedures, including left side ablations1. The TSP
technique was introduced into clinical practice during the late 1950s by
Ross et al.2 , and over the years the procedure has
remained unchanged, except for the introduction of a new needle by
Brockenbrough3 in 1960s. TSP is a relatively safe
procedure, even though complications related to TSP can be severe and
life threatening, as a consequence special training is required, and
only expert operators should perform TSP4. New
technologies have been developed in order to simplify the puncture and
increase its safety, however none of them has become the new standard
tool for TSP. Recently a novel transseptal crossing device (AcQCross™️
Qx, Medtronic) was introduced: it has an integrated needle/dilator
design, which removes the need for needle and guidewire exchange after
TSP; it fits with the different existing sheaths; and the needle can
also work with radiofrequency, in case of need. The aim of our paper is
to describe our first experience with this novel technology applied for
cryoballoon atrial fibrillation (AF) ablation, under fluoroscopy and
pressure guidance.