Key result
Radiofrequency transseptal puncture improves success and reduces complications compared to mechanical needles.
Why the study?
Transseptal puncture devices have evolved over decades, but a systematic review focusing on the development and clinical applications of radiofrequency-based puncture devices is needed.
Do radiofrequency-based transseptal puncture devices improve procedural success and safety compared to conventional mechanical needles in patients requiring left-heart access?
Do radiofrequency-based transseptal puncture devices improve procedural success and safety compared to conventional mechanical needles in patients requiring left-heart access?
Radiofrequency transseptal puncture devices offer superior precision, higher success rates, and improved safety profiles compared to conventional mechanical needles, positioning them to become the standard of care for complex left-heart interventions.
Supports radiofrequency over mechanical transseptal devices; leaves open need for randomized confirmation before practice change.
Transseptal puncture (TSP) is an indispensable step for establishing left atrial access and plays a pivotal role in complex left-heart interventions, including catheter ablation for atrial fibrillation, left atrial appendage occlusion, and transcatheter mitral valve therapy. As such, TSP ranks among the core techniques in contemporary cardiovascular interventional cardiology. Since its first description in the 1950s, TSP tools have undergone decades of iterative refinement, evolving from conventional mechanical needles to diverse energy-assisted puncture systems. The performance of a TSP system directly determines procedural success, safety, and patient prognosis. This article systematically reviews the developmental history of TSP devices, with a focused overview of the developmental background, technical evolution, clinical applications, and advantages of radiofrequency-based puncture devices (including radiofrequency guidewires and radiofrequency needles), and briefly outlines future directions for innovation.
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Wang et al. (2026) conducted a review in Conditions requiring transseptal puncture for left atrial access (e.g., atrial fibrillation, structural heart disease). Radiofrequency transseptal puncture devices vs. Conventional mechanical puncture devices was evaluated. Radiofrequency transseptal puncture devices provide higher procedural success rates and lower complication risks compared to conventional mechanical devices for establishing left atrial access.
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