Single versus double transseptal puncture for atrial fibrillation radiofrequency ablation: a systematic review and meta-analysis.

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Frontiers in Cardiovascular Medicine Pub Date : 2026-10-05 eCollection Date: 2026-01-01 DOI:10.3389/fcvm.2026.1907029

Jie Xu, Wenqiang Zhang, Feilin Ye, Junning Lei, Kun Chen, Hui Li

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引用次数: 0

Abstract

Background: The single puncture technique has emerged as an alternative to conventional double transseptal puncture for radiofrequency ablation of atrial fibrillation (AF). This meta-analysis aimed to compare the efficacy and safety of these two approaches.

Methods: We systematically searched PubMed, Embase, and the Cochrane Library up to 1st March, 2026. Prospective and retrospective cohort studies comparing single vs. double transseptal puncture during AF ablation were included. The primary outcome was the sinus rhythm maintenance. Secondary outcomes included total procedure time, fluoroscopy time, and periprocedural complications. Data were pooled using a random-effects model, and heterogeneity was assessed with the I² statistic.

Results: Four studies involving 1811 patients were included. No significant difference was observed in 3-month sinus rhythm maintenance between the single- and double-puncture groups (OR 1.20, 95% CI: 0.95-1.51, P = 0.13). While fluoroscopy time presented similar values (MD -0.84, 95% CI: -4.80-3.11, P = 0.68), procedure duration was significantly longer with single transseptal puncture (MD 11.65, 95% CI: 2.62-20.69, P = 0.01). The incidence of periprocedural complications was similar between the two strategies (OR 0.81, 95% CI: 0.47-1.38, P = 0.43).

Conclusions: Single transseptal puncture represents an effective and safe alternative to double puncture for atrial fibrillation ablation, with comparable rhythm outcomes, fluoroscopy exposure and complication rates, despite longer procedural duration.

Systematic review registration: https://www.crd.york.ac.uk/prospero/view/CRD420261300869, Identifier: CRD420261300869.

查看原文本刊更多论文

单次与双次经间隔穿刺心房颤动射频消融：系统回顾和荟萃分析。

背景：单穿刺技术已成为心房颤动（AF）射频消融的一种替代传统的双穿刺技术。本荟萃分析旨在比较这两种方法的疗效和安全性。方法：系统检索到2026年3月1日的PubMed、Embase和Cochrane Library。包括前瞻性和回顾性队列研究，比较房颤消融时单次和双次经间隔穿刺。主要结果是窦性心律维持。次要结果包括总手术时间、透视时间和术中并发症。采用随机效应模型合并数据，采用I²统计量评估异质性。结果：纳入4项研究，共1811例患者。单穿刺组和双穿刺组3个月的窦性心律维持无显著差异（OR 1.20, 95% CI: 0.95-1.51, P = 0.13）。虽然透视时间显示相似的值（MD -0.84, 95% CI: -4.80-3.11, P = 0.68），但单次经间隔穿刺的手术时间明显更长（MD 11.65, 95% CI: 2.62-20.69, P = 0.01）。两种策略的围手术期并发症发生率相似（OR 0.81, 95% CI: 0.47-1.38, P = 0.43）。结论：单次经间隔穿刺是心房颤动消融中有效且安全的替代方法，尽管手术时间较长，但其节律结果、透视暴露和并发症发生率相当。系统评价注册：https://www.crd.york.ac.uk/prospero/view/CRD420261300869，标识符：CRD420261300869。

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来源期刊

Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine

CiteScore

3.80

自引率

11.10%

发文量

3529

审稿时长

14 weeks

期刊介绍： Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.