Trial reportHeart rhythm2025
Leveraging a randomized trial to assess relationships between transeptal puncture, brain emboli, and migraine symptoms.
Trial report in Heart rhythm, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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
1 citing paper in PubMed.
- Incidence of Migraine Following Pulsed-Field Ablation for Atrial Fibrillation: Findings From a Multicenter Analysis.Journal of cardiovascular electrophysiology · 2026Article
Corrections and comments
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Authors and funding
26 authors.
Funding
Abstract
backgroundCatheter ablation procedures with transseptal punctures (usually for atrial fibrillation) are often associated with migraine-related visual auras, but the mechanism remains unknown. Whether this phenomenon is mediated by the creation of an atrial septal defect from transseptal puncture or by silent acute brain emboli detected on magnetic resonance imaging related to the procedure remains to be investigated.
objectiveThis study aimed to evaluate whether randomization to a transseptal puncture during catheter ablation for ventricular arrhythmias is associated with postprocedural visual auras and assess the relationship between occipital and parietal lobes acute brain emboli and migraine-related visual auras.
methodsIn the Transseptal Versus Retrograde Aortic Ventricular Entry to Reduce Systemic Emboli trial, patients undergoing catheter ablation for ventricular arrhythmias were randomized to ventricular access via transseptal puncture vs a retrograde aortic approach. All had brain magnetic resonance imaging the day after their procedure and underwent a validated migraine assessment at 1 month.
resultsNo differences in postablation visual auras were observed between transseptal (16% of 63) and retrograde aortic approaches (14% of 57; P = .78). However, more participants with acute brain emboli in the occipital or parietal lobes experienced migraine-related visual auras (38% vs 11%; P < .01). After multivariable adjustment, the presence of acute brain emboli was associated with 12-fold greater odds of visual auras.
conclusionTransseptal puncture was not associated with visual auras; however, acute brain emboli involving the visual cortex were associated with such symptoms. These data suggest that transseptal puncture is not causal in migraine-related visual auras and that postprocedure acute brain emboli are apparently not always clinically silent.
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