Single versus double transseptal puncture for atrial fibrillation radiofrequency ablation: a systematic review and meta-analysis.
- 1Department of Cardiology, 986th Hospital, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
- 2Department of Anatomy, Histology and Embryology and K.K. Leung Brain Research Center, Fourth Military Medical University, Xi'an, China.
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.
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BibTeX
@article{xu2026single,
title = {{Single versus double transseptal puncture for atrial fibrillation radiofrequency ablation: a systematic review and meta-analysis.}},
author = {Jie Xu and Wenqiang Zhang and Feilin Ye and Junning Lei and Kun Chen and Hui Li},
journal = {Frontiers in cardiovascular medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1907029},
url = {https://europepmc.org/article/MED/42898279},
note = {CC BY},
}
RIS
TY - JOUR
TI - Single versus double transseptal puncture for atrial fibrillation radiofrequency ablation: a systematic review and meta-analysis.
AU - Jie Xu
AU - Wenqiang Zhang
AU - Feilin Ye
AU - Junning Lei
AU - Kun Chen
AU - Hui Li
PY - 2026
DA - 2026/10/05
JO - Frontiers in cardiovascular medicine
DO - 10.3389/fcvm.2026.1907029
UR - https://europepmc.org/article/MED/42898279
AB - 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.
SN - 2297-055X
ER -