Work

Straightening Trapped Duodecapolar Catheter Loop in IVC via Contralateral Subclavian Deflectable Catheter

Year: 2026

Type: article

Abstract: OBJECTIVE: To present a simple, reproducible technique to release inferior vena cava (IVC) loop entrapment of a duodecapolar catheter using contralateral subclavian access and a deflectable ablation catheter. KEY STEPS: After a trapped duodecapolar catheter in the IVC, stop traction and confirm the IVC loop using biplane fluoroscopy. Obtain a separate contralateral (left) subclavian venous access with an 8- to 9-F sheath. Advance a deflectable ablation catheter to the IVC via left subclavian access, engage the loop apex, and apply controlled upward traction to straighten the loop. Remove the trapped catheter intact and reverify the ablation endpoints. POTENTIAL PITFALLS: Potential pitfalls included the following: misidentifying right atrial vs IVC loops, escalating traction, inadequate subclavian support, and failure to reconfirm cavotricuspid isthmus block/pulmonary vein isolation endpoints. TAKE-HOME MESSAGE: A deflectable catheter placed using contralateral access site can free IVC loop entrapment rapidly without snares.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.106408

Authors: Apurva Popat, Sharath Kommu, Param Sharma

Institutions: Marshfield Clinic, Marshfield Clinic, Marshfield Clinic

Language: English

Topic: Cardiac Arrhythmias and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850