Key result
Unilateral groin puncture-single trans-septal ablation for paroxysmal atrial fibrillation resulted in a similar major complication rate (2.0% vs 2.7%) compared to the conventional bilateral approach, while significantly reducing post-procedural discomfort.
Why the study?
Catheter ablation for AF requires heavy anticoagulation and uncomfortable post-procedural hemostasis, prompting comparison of patient satisfaction and safety between unilateral and conventional bilateral groin puncture approaches.
Does unilateral groin puncture-single trans-septal ablation reduce post-procedural discomfort and maintain safety compared to bilateral groin puncture-double trans-septal ablation in patients with paroxysmal AF?
RCT (n=222)
Single-blind
2:1
Yes
Does unilateral groin puncture-single trans-septal ablation reduce post-procedural discomfort and maintain safety compared to bilateral groin puncture-double trans-septal ablation in patients with paroxysmal AF?
Absolute Event Rate: 2% vs 2.7%
p-value: p=>0.999
Unilateral groin puncture with single trans-septal ablation is a feasible, safe, and more comfortable alternative to the conventional bilateral approach for paroxysmal AF ablation.
Supports unilateral single-access ablation to minimize discomfort in paroxysmal AF; extends RCT evidence for simplified trans-septal strategies.
PURPOSE: Catheter ablation for atrial fibrillation (AF) requires heavy anticoagulation and uncomfortable post-procedural hemostasis. We compared patient satisfaction with and the safety of unilateral groin (UG) puncture-single trans-septal (ST) ablation with conventional bilateral groin (BG) puncture-double trans-septal (DT) ablation in paroxysmal AF patients. MATERIALS AND METHODS: We enrolled 222 patients with paroxysmal AF (59.4±10.7 years old) who were randomized in a 2:1 manner into UG-ST ablation (n=148) and BG-DT ablation (n=74) groups. If circumferential pulmonary vein isolation could not be achieved after three attempts of touch-up ablation in the UG-ST group, the patient was crossed over to BG-DT by performing a left groin puncture. CONCLUSION: UG-ST AF ablation is feasible and safe, and was found to significantly reduce post-procedural hemostasis-related discomfort, compared to the conventional DT approach, in patients with paroxysmal AF.
No takes yet. Share an insight, caveat, or question.
Yu et al. (2019) conducted an RCT in Paroxysmal atrial fibrillation (n=222). Unilateral groin puncture-single trans-septal (UG-ST) ablation vs. Bilateral groin puncture-double trans-septal (BG-DT) ablation was evaluated on Major complications within 30 days (p=>0.999). Unilateral groin puncture-single trans-septal ablation for paroxysmal atrial fibrillation resulted in a similar major complication rate (2.0% vs 2.7%) compared to the conventional bilateral approach, while significantly reducing post-procedural discomfort.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: