Systems and methods for penetrating a tissue membrane to gain access to a
target site are disclosed. In some examples, systems and methods for
accessing the left atrium from the right atrium of a patient's heart are
carried out by puncturing the intra-atrial septal wall. One embodiment
provides a system for transseptal cardiac access that includes a guiding
catheter, an access catheter and a guidewire. The access catheter may
include a tissue penetration member disposed within a housing wherein the
tissue penetration member is substantially contained within the housing
when in a retracted configuration. When the distal end of the access
catheter is disposed adjacent the septal wall, the user can initiate an
actuator switch, which may be in a proximal portion of the system, to
cause the tissue penetration member to extend through the septal wall.
Alternatively, the tissue penetration member can be actuated
automatically by a contact trigger mechanism, without initiation by the
user, upon contact with the septal wall by a distal contact member which
is coupled to the contact trigger mechanism. Such a system may also
include an interlock mechanism to prevent triggering of the tissue
penetration member at undesirable times during a procedure.