ArticlePacing and clinical electrophysiology : PACE2020
Safety and efficacy of zero fluoroscopy transseptal puncture with different approaches.
Article in Pacing and clinical electrophysiology : PACE, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Zero-fluoroscopy versus fluoroscopy-guided catheter ablation in ventricular arrhythmia: A systematic review and meta-analysis.Narra J · 2025Pooled it
- Angioplasty Guidewire-Assisted vs. Conventional Transseptal Puncture for Left Atrial Appendage Occlusion: a multicentre randomized controlled trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Trial
- Zero Fluoroscopy Catheter Ablation of Accessory Pathways and AV Nodal Re-Entry Tachycardia: A Single Institution Study.Pacing and clinical electrophysiology : PACE · 2026Review
- Step-by-Step: How to Perform Pulsed Field Ablation of Atrial Fibrillation Guided Exclusively by Intracardiac Echocardiography Using a Pentaspline Catheter.Journal of cardiovascular electrophysiology · 2026Review
- Comparison of Two ICE-Guided Transseptal Puncture Strategies for Zero-Fluoroscopy AF Ablation-A Randomized Controlled Trial.Journal of arrhythmia · 2026Article
- Modified intracardiac echocardiography (ICE)-guided transseptal puncture under ablation catheter guidance.BMC cardiovascular disorders · 2025Article
- Multicenter Practice of Non/Minimized Fluoroscopy Ablation for Paroxysmal AF in China: The PAF-ICE Trial.JACC. Asia · 2025Article
- The use of cardiac imaging in patients undergoing atrial fibrillation ablation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Review
- Outcomes of pulsed-field ablation with low to zero fluoroscopy utilization for atrial fibrillation treatment.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- An Antiquated Concept in the Novel Era of Ablation: Zero-fluoroscopy Pulsed Field Ablation for Treatment of Atrial Fibrillation.The Journal of innovations in cardiac rhythm management · 2025Article
- Left atrial intramural hematoma during radiofrequency catheter ablation for atrial fibrillation: The important role of intracardiac echocardiography.HeartRhythm case reports · 2025Article
- Intracardiac echocardiography, electroanatomical mapping, and the obsolescence of fluoroscopy for catheter ablation procedures.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024Article
- Initial experience with zero-fluoroscopy pulmonary vein isolation in patients with atrial fibrillation: single-center observational trial.Scientific reports · 2024Observational
- Intracardiac Echocardiography: An Invaluable Tool in Electrophysiological Interventions for Atrial Fibrillation and Supraventricular Tachycardia.Reviews in cardiovascular medicine · 2024Review
- Nonlinear beamforming for intracardiac echocardiography: a comparative study.Biomedical engineering letters · 2024Article
- Optimizing transseptal puncture guided by three-dimensional mapping: the role of a unipolar electrogram in a needle tip.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Zero-fluoroscopy transseptal puncture guided by right atrial high-density precision mapping.Heart rhythm O2 · 2024Article
- Best practices in robotic magnetic navigation-guided catheter ablation of cardiac arrhythmias, a position paper of the Society for Cardiac Robotic Navigation.Frontiers in cardiovascular medicine · 2024Review
- Intracardiac echocardiography is a promising strategy for guiding closure of the left atrial appendage.Health science reports · 2023Review
- Zero-Fluoroscopy Catheter Ablation of Supraventricular Tachycardias in the Pediatric Population.Children (Basel, Switzerland) · 2023Article
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
Abstract
introductionAtrial fibrillation (AF) ablation requires access to the left atrium (LA) via transseptal puncture (TP). TP is traditionally performed with fluoroscopic guidance. Use of intracardiac echocardiography (ICE) and three-dimensional mapping allows for zero fluoroscopy TP.
objectiveTo demonstrate safety and efficacy of zero fluoroscopy TP using multiple procedural approaches.
methodsPatients undergoing AF ablation between January 2015 and November 2017 at five institutions were included. ICE and three-dimensional mapping were used for sheath positioning and TP. Variable technical approaches were used across centers including placement of J wire in the superior vena cava with ICE guidance followed by dragging down the transseptal sheath into the interatrial septum, or guiding the transseptal sheath directly to the interatrial septum by localizing the ablation catheter with three-dimensional mapping and replacing it with the transseptal needle once in position. In patients with pacemaker/implantable cardiac defibrillator leads, pre-/poststudy device interrogation was performed.
resultsA total of 747 TPs were performed (646 patients, age 63.1 ± 13.1, 67.5% male, LA volume index 34.5 ± 15.8 mL/m
conclusionTP can be safely and effectively performed without the need for fluoroscopy.
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