Double Transseptal Access for Atrial Fibrillation Ablation in the Presence of Investigational Interatrial Shunt Device

Abstract Transseptal access for atrial fibrillation ablation can be challenging in the presence of iatrogenically modified interatrial septum. We report the first described transseptal left atrial access for atrial fibrillation ablation in the presence of an investigational interatrial shunt device, performed in a patient with heart failure with preserved ejection fraction. (Level of Difficulty: Intermediate.)