Arrhythmias & electrophysiology
Transseptal puncture for catheter ablation of atrial fibrillation in patients with septal occluder devices
Authors' conclusion
TSP and PVI are safe and can be safely performed in patients with an ASO. No additional substrate related to the occluder was seen. Although no direct comparison was made, outcomes align with existing literature. Further studies are needed.
Study context
- Population
- Patients with drug-refractory atrial fibrillation (AF) and atrial septal occluders (ASOs) in situ for atrial septal defects (ASDs) or persistent foramen ovale (PFO) who underwent pulmonary vein isolation (PVI) between 2019 and 2024mean age 61.2 ± 12.1 years, 56% male · ASDs 38 · PFOs 21
- Participants
- 59 patients
- Outcome
- TSP position in the interatrial septum related to the ASO
Main finding
As reported in the abstract
Inferior-posterior to the ASO
66.1%
Inferior-anterior
23.7%
Superior-posterior puncture (in case of failure of the inferior part)
8.5%
Puncture through the occluder (in case of failure of the inferior part)
1.7%
Observational data: associations, not effects.
Further findings
Ablation time and energy source
- Mean ablation time
- 14.9 ± 8.4 minutes
- Radiofrequency
- 83.0%
- Cryoballoon
- 11.9%
- Pulsed field ablation
- 5.1%
Voltage mapping
- No additional substrate related to the occluder
AF recurrence · 12-month follow-up
- Patients with AF recurrence
- 7 patients (11.9%)
Safety
- Transient phrenic nerve palsy during cryoballoon ablation, recovered intraprocedurally
- 1
- No major complications
Original publication
Transseptal puncture for catheter ablation of atrial fibrillation in patients with septal occluder devices. Heart Rhythm. Published 3 April 2025. doi:10.
Summarised from the published abstract; every number is checked against it