# Accusafe guidewire for atrial septal puncture: dual-imaging safety and efficacy: a case report

## TL;DR

A new guidewire technique improves safety during heart procedures in a patient with atrial fibrillation and heart failure.

## Contribution

Introduces a novel ASP technique using the Accusafe guidewire with dual-imaging guidance for complex cardiac procedures.

## Key findings

- The Accusafe guidewire technique successfully enabled ASP under dual imaging guidance.
- The method may enhance safety and precision in complex procedures like LAA closure.
- This approach could be beneficial for patients with anticoagulation-related complications.

## Abstract

A 74-year-old female with nonvalvular atrial fibrillation and heart failure, on rivaroxaban 20 mg/day, presented for left atrial appendage (LAA) closure due to recurrent hematomas despite anticoagulation therapy. This case report describes an innovative atrial septal puncture (ASP) technique utilizing the Accusafe guidewire (Synaptic Medical, Beijing, China) under combined fluoroscopic and intracardiac echocardiography (ICE) guidance. The procedure was successful, demonstrating that this method may enhance procedural safety and precision, particularly in complex cases such as LAA closure, atrial fibrillation ablation, and MitraClip procedures.