June 26, 2026
View Full PaperTrans-Septal Catheterization in the Electrophysiology Laboratory
Key Result
Trans-septal catheterization for arrhythmia ablation was successfully performed in 99.1% of cases, with a low complication rate of 0.74% to 0.79%.
Key Points
- To evaluate the use, success rates, and complications of trans-septal catheterization for ablation of arrhythmias in the left heart.
- Retrospective survey involving 33 centers in Italy.
- Data collected for 5,520 procedures, including indications, accomplishments, complications, and reasons for failure.
- Analysis covered procedures from 1992 to 2003, with emphasis on 2003 data.
- Trans-septal catheterization was successfully performed in 99.1% of cases.
- Most procedures (78.3%) were for atrial fibrillation ablation in 2003.
- Complications were low at 0.79% in 2003 and 0.74% in previous years.
Study Design
Type
Observational (n=5,520)
Multicenter
Yes
Structured PICO
What are the success and complication rates of trans-septal catheterization for arrhythmia ablation in the electrophysiology laboratory?
P
Population
5,520 trans-septal catheterization procedures for arrhythmia ablation collected retrospectively from 33 Italian centers.
E
Exposure
Trans-septal catheterization (TSP-C)
O
Outcome
Procedural success (accomplishment rate) and complication ratesafety
Trans-septal catheterization in the electrophysiology laboratory is highly successful (99.1%) and safe, primarily driven by the increasing need for atrial fibrillation ablation.
Abstract
OBJECTIVES: We report the data from the Italian Survey on trans-septal catheterization (TSP-C) for catheter ablation of arrhythmias in the left heart that covered 2003 and previous years. BACKGROUND: Over the last decade the use of TSP-C in the electrophysiology laboratory has greatly increased. Recent data on number of procedures, accomplishment rate, and complications related to this procedure are lacking in a large cohort of patients. METHODS: Thirty-three centers participated in the survey. The data collected retrospectively for 2003 included the number of procedures, indications, methods, and the number and reason for unaccomplished cases along with complications. Retrospective data collected for previous years included the annual number of procedures and cumulative data concerning indications, accomplishments, and complications. RESULTS: Since 1992, 5,520 TSP-C procedures were used in arrhythmia ablation, with the peak increase in the use occurring in 2001. Trans-septal catheterization was performed for atrial fibrillation (AF) ablation in 78.3% of the procedures in 2003. The electrophysiologist independently performed the procedure in 29 of 33 centers. Trans-septal catheterization was successfully performed in 99.1% of the cases; the main reason for TSP-C not being performed was related to fossa ovalis/atrial septum anatomy. Complications were low both in 2003 and in the previous years (0.79% and 0.74%, respectively). CONCLUSIONS: Trans-septal catheterization in the electrophysiology laboratory is associated with a high success and low complication rate. The use of TSP-C has progressively increased over the last decade and is currently used primarily for AF ablation. Although possible, severe complications were rare.