Abstract
v A 62-year-old lady presented with symptomatic persistent atrial fibrillation. An attempt at left atrial ablation (LAA) was abandoned following difficulty in performing transseptal puncture under fluoroscopic guidance alone and concern that the puncture had caused right atrial puncture into the pericardial space. Echocardiography at the time demonstrated a small rim of pericardial fluid that was managed conservatively. Left ventricular pressure readings noted at the time were felt to represent the catheter having crossed the mitral valve following left atrial puncture during this compli-
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