Acuson acunav

Procedures were preferably performed in conscious sedation, except for patients undergoing epicardial approach in whom general anaesthesia was used. Femoral vein and artery punctures were performed to access the heart. A 3D EAM system (Carto®, Biosense Webster, Irvine, California, USA or NavX™ Precision™, Abbott, Abbott Park, Illinois, USA) and intra-cardiac echocardiography (ICE) (Acuson AcuNav™, Biosense Webster, Irvine, California, USA) were routinely used simultaneously. In patients with left-sided arrhythmias, we generally used the ante-grade trans-septal approach, except when mapping and ablation in the aortic root were needed in which case a retrograde trans-aortic approach was used. A steerable long sheath (Agilis™, LRG Curl, Abbott, Abbott Park, Illinois, USA) was used to improve catheter stability in trans-septal approach. Typically, uni-directional irrigated tip radio-frequency (RF) ablation catheters with (Thermocool Smarttouch® and Thermocool Smarttouch® SF, both Biosense Webster, Irvine, California, USA) and without (FlexAbility™, Abbott, Abbott Park, Illinois, USA) the ability of contact force sensing were utilised. In patients with SHD and suspected substantial arrhythmogenic substrate we used a multipolar catheter enabling high-density mapping (PentaRay®, Biosense Webster, Irvine, California, USA).