Abstract
BackgroundWe have previously reported that unilateral groin‐single transseptal (ST) ablation in patients with paroxysmal atrial fibrillation (AF) was safe and significantly reduced patient discomfort compared with bilateral groin‐double transseptal (DT) ablation.HypothesisIn the present study, we hypothesized that ST ablation would be as effective and safe as DT ablation in real‐world practice like previous study. Among the 1765 consecutive patients in the Yonsei AF ablation cohort from October 2015 to January 2020, 1144 patients who underwent radiofrequency ablation were included for the analysis. Among them, 450 underwent ST ablation and 694 underwent DT ablation.ResultsThe total procedure time, ablation time, and fluoroscopy time were longer in the ST group than in the DT group (p < .05 for all). The hospital stay after catheter ablation was 1.3 ± 1.1 days which was longer in DT group than ST group (p = .001). No significant difference was observed in the complication rate (p = .263) and AF‐free survival rate (log‐rank p = .19) between the groups. However, after excluding patients who used antiarrhythmic drugs when AF recurred, the AF‐free survival rates were lower in the DT group than in the ST group before and after propensity score matching (log‐rank p = .026 and .047, respectively).ConclusionAlthough the ST approach increases the procedure time compared with the DT approach owing to the need for more frequent catheter exchanges, the ST approach is a feasible and safe strategy for AF ablation in terms of rhythm outcomes and risk of complications.
Highlights
Catheter ablation is effective in rhythm control of atrial fibrillation (AF) and maintaining sinus rhythm.[1,2,3,4,5] After a study identified triggers of paroxysmal AF in the pulmonary veins (PVs), catheter ablation of AF has become a more common treatment method.[6,7] Complete PV isolation is a well-proven endpoint for catheter ablation by encircling the PVs.[8,9] To approach the PVs via the left atrium (LA) during AF ablation, transseptal puncture is performed.[10]
There was no significant difference in PV reconnection between single transseptal (ST) group and double transseptal (DT) group
Selecting the ST or DT approach was decided by operator preference and it could result in selection bias
Summary
Catheter ablation is effective in rhythm control of atrial fibrillation (AF) and maintaining sinus rhythm.[1,2,3,4,5] After a study identified triggers of paroxysmal AF in the pulmonary veins (PVs), catheter ablation of AF has become a more common treatment method.[6,7] Complete PV isolation is a well-proven endpoint for catheter ablation by encircling the PVs.[8,9] To approach the PVs via the left atrium (LA) during AF ablation, transseptal puncture is performed.[10]. We have previously compared unilateral groin (UG) puncturesingle transseptal (ST) ablation with the conventional bilateral groin (BG) puncture-double transseptal (DT) ablation in a prospective randomized trial.[16] No differences in clinical outcome and complications were found between the two groups. The number of patients in our previous prospective study was relatively small. In the present study, we sought to assess the effectiveness and safety of ST ablation compared to those of DT ablation in patients with AF in real-world clinical practice
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
