ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2026
Transseptal puncture and catheter ablation of atrial fibrillation in patients with atrial septal occluder devices: procedural techniques and outcomes.
Article in 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. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Long-Term Outcome After Pulsed Field Ablation for Atrial Fibrillation Across an Atrial Septal Defect Closure Device: A 20-Month Follow-Up Case Report.Clinical case reports · 2026Article
- Efficacy and safety of transseptal puncture-assisted atrial fibrillation ablation in patients with atrial septal occluder devices: an updated systematic review and meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Review
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15 authors.
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Abstract
aimsTransseptal puncture (TSP) for left atrial (LA) access during catheter ablation poses technical challenges in patients with an atrial septal occluder (ASO) device because of altered septal anatomy and device coverage. However, detailed procedural techniques remain insufficiently described. This study aimed to describe a practical, case-based approach to TSP in patients with ASO devices and to evaluate procedural outcomes.
methodsBetween March 2005 and September 2025, a total of 1550 patients underwent ASO device implantation at our institution. Among them, 28 consecutive patients who later underwent atrial fibrillation (AF) ablation between March 2017 and September 2025 were retrospectively analysed. A representative clinical case illustrates the procedural workflow.
resultsTransseptal access was successfully achieved in 27 of 28 patients (96.4%). TSP was performed through the native septum in 17 patients and through the ASO device in 11 patients. Balloon dilation was frequently required in device puncture cases. Pulmonary vein isolation and adjunctive ablation were successfully completed in all patients without major complications. Small residual interatrial shunts observed immediately after the procedure resolved spontaneously during follow-up.
conclusionTSP and AF ablation can be performed safely and effectively in patients with ASO devices. A case-based procedural approach with appropriate imaging guidance enables reliable LA access even in the presence of an ASO device.
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