Arrhythmias & electrophysiologyRandomised controlled trial
Angioplasty Guidewire-Assisted vs. Conventional Transseptal Puncture for Left Atrial Appendage Occlusion: a multicentre randomized controlled trial
- Randomised controlled trial
- investigator-initiated
- prospective
- multicentre
Authors' conclusion
This study confirmed that angioplasty guidewire-assisted puncture can effectively improve the success rate of TSP during LAAO procedures.
Study context
- Population
- Patients with AF undergoing left atrial appendage occlusion (LAAO), four centres
- Participants
- 131 vs 132
- Comparison
- Guidewire-assisted transseptal puncture (TSP) vs Conventional TSP
- Guidewire-assisted TSPn = 131
- Conventional TSPn = 132reference
- Primary endpoint
- One-time success rate of TSP
Primary result
As reported in the abstract
P = 0.001
Further findings
TSP procedure time
P = 0.023
Good coaxial orientation of sheath with left atrial appendage
P = 0.059
| Outcome | Guidewire-assisted TSP | Conventional TSP | P value |
|---|---|---|---|
| Crossover to guidewire-assisted approach | Not reported in the abstract | 5 events |
Crossover to guidewire-assisted approach
- All patients in the guidewire-assisted group underwent successful TSP
Failure rate of assigned TSP type, total procedure time, total radiation dose, successful LAAO implantation
- No significant difference between the two groups
- all P > 0.05
Safety
events
| Outcome | Guidewire-assisted TSP | Conventional TSP |
|---|---|---|
| TSP-related complications | 0 | 2 |
- TSP-related complications — No significant difference in procedural complication rate
- all P > 0.05
Original publication
Angioplasty Guidewire-Assisted vs. Conventional Transseptal Puncture for Left Atrial Appendage Occlusion: a multicentre randomized controlled trial. Europace. Published 27 November 2023. doi:10.1093/europace/euad349
Summarised from the published abstract; every number is checked against it