Evidence map›Paper›PMID 35671359›Full record

ArticleJournal of cardiovascular electrophysiology2022

Transseptal puncture for left atrial ablation: Risk factors for cardiac tamponade and a proposed causative classification system.

Edd Maclean, Karishma Mahtani, Marina Roelas, Rohan Vyas, Charles Butcher, Nikhil Ahluwalia, Shohreh Honarbakhsh, Antonio Creta, Malcolm Finlay, Anthony Chow and 12 more

Abstract read
In one paragraph

Article in Journal of cardiovascular electrophysiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Intracardiac Echocardiography during Invasive Electrophysiological Procedures: a Scientific Statement of the European Heart Rhythm Association of the ESC, and the European Association of Percutaneous Cardiovascular Interventions of the ESC.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 · 2026
    Guideline
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  11. 2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.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 · 2024
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors.

Edd MacleanDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.ORCID 0000-0001-6177-2221
Karishma MahtaniDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.ORCID 0000-0002-0467-6732
Marina RoelasDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Rohan VyasDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Charles ButcherDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Nikhil AhluwaliaDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.ORCID 0000-0003-1257-5576
Shohreh HonarbakhshDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Antonio CretaDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Malcolm FinlayDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Anthony ChowDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Mark EarleyDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Simon SportonDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Martin LoweDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Vinit SawhneyDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Vivienne EzzatDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Syed AhsanDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Fakhar KhanDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Mehul DhinojaDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Pier LambiaseDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Richard SchillingDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Ross HunterDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.
Oliver SegalDepartment of Cardiac Electrophysiology, Barts Heart Center, St. Bartholomew's Hospital, W Smithfield, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsCardiac tamponade is a high morbidity complication of transseptal puncture (TSP). We examined the associations of TSP-related cardiac tamponade (TRCT) for all patients undergoing left atrial ablation at our center from 2016 to 2020. METHODS AND

resultsPatient and procedural variables were extracted retrospectively. Cases of cardiac tamponade were scrutinized to adjudicate TSP culpability. Adjusted multivariate analysis examined predictors of TRCT. A total of 3239 consecutive TSPs were performed; cardiac tamponade occurred in 51 patients (incidence: 1.6%) and was adjudicated as TSP-related in 35 (incidence: 1.1%; 68.6% of all tamponades). Patients of above-median age [odds ratio (OR): 2.4 (1.19-4.2), p = .006] and those undergoing re-do procedures [OR: 1.95 (1.29-3.43, p = .042] were at higher risk of TRCT. Of the operator-dependent variables, choice of transseptal needle (Endrys vs. Brockenbrough, p > .1) or puncture sheath (Swartz vs. Mullins vs. Agilis vs. Vizigo vs. Cryosheath, all p > .1) did not predict TRCT. Adjusting for operator, equipment and demographics, failure to cross the septum first pass increased TRCT risk [OR: 4.42 (2.45-8.2), p = .001], whilst top quartile operator experience [OR: 0.4 (0.17-0.85), p = .002], transoesophageal echocardiogram [TOE prevalence: 26%, OR: 0.51 (0.11-0.94), p = .023], and use of the SafeSept transseptal guidewire [OR: 0.22 (0.08-0.62), p = .001] reduced TRCT risk. An increase in transseptal guidewire use over time (2016: 15.6%, 2020: 60.2%) correlated with an annual reduction in TRCT (R

conclusionsDuring left atrial ablation, the risk of TRCT was reduced by operator experience, TOE-guidance, and use of a transseptal guidewire, and was increased by patient age, re-do procedures, and failure to cross the septum first pass.

Indexed as

Atrial FibrillationCardiac TamponadeCatheter AblationCardiac CatheterizationHumansPuncturesRetrospective StudiesRisk FactorsTreatment Outcomecardiac tamponadeSafeSept guidewiretransoesophageal echocardiogramtransseptal puncture

Identifiers

PMID35671359
PMCPMC9543389

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.