{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:32:45Z","timestamp":1781659965175,"version":"3.54.5"},"reference-count":14,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Percutaneous left atrial appendage occlusion (LAAO) is traditionally performed under general anesthesia with trans\u2010esophageal echocardiography guidance. Intracardiac echo (ICE)\u2010guided LAAO closure is increasing in clinical use. The ICE catheter is crossed into LA via interatrial septum (IAS) after the septum is dilated with LAAO delivery sheath. This step can be time\u2010consuming and requires significant ICE catheter manipulation, which increases the risk of cardiac perforation. Pre\u2010emptive septal balloon dilation can potentially help with ICE advancement in the LA. We sought to evaluate the effect of pre\u2010dilation of the IAS with an 8\u2009mm balloon on the ease of crossing the ICE catheter, fluoroscopy time for crossing, and overall procedure time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Piedmont LAAO registry was used to identify consecutive patients who underwent LAAO. The initial 25 patients in whom balloon dilation of the IAS was performed served as the experimental cohort, and the 25 consecutive patients before that in whom balloon dilation was not performed served as controls. In the experimental group, after a trans\u2010septal puncture, the sheath was retracted to the right atrium with a guidewire still in the LA. An 8\u2009\u00d7\u200940\u2009mm Evercoss\u2122 over the wire balloon was inflated across the IAS. The ICE catheter was then crossed into the LA using the fluoroscopic landmark of the guide wire and the ICE imaging. The sheath was then advanced along the ICE catheter via the transseptal puncture (TSP) and the procedure continued. Follow\u2010up compputed tomography imaging was obtained at 4\u20138 weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Each group consisted of 25 patients. There were no significant differences in baseline characteristics. All procedures were performed successfully under conscious sedation and ICE guidance. There was a significant reduction in the overall procedure time, fluoroscopy time, and time for transseptal puncture to ICE in LA. There was no difference in the size of the acute residual interatrial shunt, as measured via ICE, or the size and presence of iatrogenic ASD at follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Balloon dilation of TSP is safe and is associated with increased efficiency in ICE\u2010guided LAAO procedures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16243","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T07:09:35Z","timestamp":1711004975000},"page":"1078-1082","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Inter\u2010atrial septal balloon dilation to facilitate intracardiac echocardiography guided left atrial appendage occlusion"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6915-9835","authenticated-orcid":false,"given":"Sandeep K.","family":"Goyal","sequence":"first","affiliation":[{"name":"Division of Electrophysiology Piedmont Heart Institute Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2857-3209","authenticated-orcid":false,"given":"Ashish A.","family":"Bhimani","sequence":"additional","affiliation":[{"name":"Division of Electrophysiology Piedmont Heart Institute Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4657-1944","authenticated-orcid":false,"given":"Danesh K.","family":"Kella","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9841-1165","authenticated-orcid":false,"given":"Anahita","family":"Tyagi","sequence":"additional","affiliation":[{"name":"Division of Electrophysiology Piedmont Heart Institute Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6576-1297","authenticated-orcid":false,"given":"Venkateshwar","family":"Polsani","sequence":"additional","affiliation":[{"name":"Division of Cardiac imaging Piedmont Heart Institute Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6046-5083","authenticated-orcid":false,"given":"Thomas F.","family":"Deering","sequence":"additional","affiliation":[{"name":"Division of Electrophysiology Piedmont Heart Institute Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"issue":"140","key":"e_1_2_8_2_1","first-page":"e125","article-title":"AHA\/ACC\/HRS focused update of the 2014 AHA\/ACC\/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in collaboration with the Society of Thoracic Surgeons","volume":"2019","author":"January CT","year":"2019","journal-title":"Circulation"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.04.029"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.057063"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.050117"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2019.11.014"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.06.057"},{"key":"e_1_2_8_8_1","first-page":"538","article-title":"Intracardiac echocardiography versus transesophageal echocardiography for left atrial appendage closure: an updated meta\u2010analysis and systematic review","volume":"10","author":"Jhand A","year":"2020","journal-title":"Am J Cardiovasc Dis"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.01.014"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27246"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytac365"},{"key":"e_1_2_8_12_1","unstructured":"The Case for Intracardiac Echo to Guide Left Atrial Appendage Closure\u2014ClinicalKey. 2023.\u00a0https:\/\/www.clinicalkey.com\/#!\/content\/journal\/1-s2.0-S2211745821001115"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-023-01913-7"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.4022\/jafib.2200"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.15251"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.16243","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T04:33:36Z","timestamp":1720499616000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.16243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,21]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1111\/jce.16243"],"URL":"https:\/\/doi.org\/10.1111\/jce.16243","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,21]]},"assertion":[{"value":"2024-01-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}