{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:26:27Z","timestamp":1792794387661,"version":"4.5.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T00:00:00Z","timestamp":1672790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"University Hospital Freiburg","id":[{"id":"https:\/\/ror.org\/03vzbgh69","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Transseptal puncture (TP) for left-sided catheter ablation procedures is routinely performed under fluoroscopic or echocardiographic guidance [transoesophageal echocardiography (TEE) or intracardiac echocardiography (ICE)], although three-dimensional (3D) mapping systems are readily available in most electrophysiology laboratories. Here, we sought to assess the feasibility and safety of a right atrial (RA) 3D map\u2013guided TP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In 104 patients, 3D RA mapping was performed to identify the fossa ovalis (FO) using the protrusion technique. The radiofrequency transseptal needle was visualized and navigated to the desired potential FO-TP site. Thereafter, the interventionalist was unblinded to TEE and the potential FO-TP site was reassessed regarding its convenience and safety. After TP, the exact TP site was documented using a 17-segment-FO model. Reliable identification of the FO was feasible in 102 patients (98%). In these, 114 3D map\u2013guided TP attempts were performed, of which 96 (84%) patients demonstrated a good position and 18 (16%) an adequate position after TEE unblinding. An out-of-FO or dangerous position did not occur. A successful 3D map\u2013guided TP was performed in 110 attempts (97%). Four attempts (3%) with adequate positions were aborted in order to seek a more convenient TP site. The median time from RA mapping until the end of the TP process was 13 (12\u201317) min. No TP-related complications occurred. Ninety-eight TP sites (85.1%) were in the central portion or in the inner loop of the FO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A 3D map\u2013guided TP is feasible and safe. It may assist to decrease radiation exposure and the need for TEE\/ICE during left-sided catheter ablation procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euac262","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T19:03:20Z","timestamp":1671217400000},"page":"1126-1134","source":"Crossref","is-referenced-by-count":17,"title":["Feasibility and safety of a three-dimensional anatomic map\u2013guided transseptal puncture for left-sided catheter ablation procedures"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6978-9973","authenticated-orcid":false,"given":"Marius","family":"Bohnen","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology (Campus Bad Krozingen), Heart Center, University Hospital Freiburg , S\u00fcdring 15, 79189 Bad Krozingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7094-8348","authenticated-orcid":false,"given":"Jan","family":"Minners","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology (Campus Bad Krozingen), Heart Center, University Hospital Freiburg , S\u00fcdring 15, 79189 Bad Krozingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3674-790X","authenticated-orcid":false,"given":"Martin","family":"Eichenlaub","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology (Campus Bad Krozingen), Heart Center, University Hospital Freiburg , S\u00fcdring 15, 79189 Bad Krozingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhold","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology (Campus Bad Krozingen), Heart Center, University Hospital Freiburg , S\u00fcdring 15, 79189 Bad Krozingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-J\u00fcrgen","family":"Allgeier","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology (Campus Bad Krozingen), Heart Center, University Hospital Freiburg , S\u00fcdring 15, 79189 Bad Krozingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6402-2845","authenticated-orcid":false,"given":"Amir","family":"Jadidi","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology (Campus Bad Krozingen), Heart Center, University Hospital Freiburg , S\u00fcdring 15, 79189 Bad Krozingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0921-8351","authenticated-orcid":false,"given":"Franz-Josef","family":"Neumann","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology (Campus Bad Krozingen), Heart Center, University Hospital Freiburg , S\u00fcdring 15, 79189 Bad Krozingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7542-1956","authenticated-orcid":false,"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology (Campus Bad Krozingen), Heart Center, University Hospital Freiburg , S\u00fcdring 15, 79189 Bad Krozingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Arentz","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology (Campus Bad Krozingen), Heart Center, University Hospital Freiburg , S\u00fcdring 15, 79189 Bad Krozingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Lehrmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology (Campus Bad Krozingen), Heart Center, University Hospital Freiburg , S\u00fcdring 15, 79189 Bad Krozingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,1,4]]},"reference":[{"key":"2023033021232476600_","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1093\/europace\/eut409","article-title":"Practical ways to reduce radiation dose for patients and staff during device implantations and electrophysiological procedures","volume":"16","author":"Heidbuchel","year":"2014","journal-title":"Europace"},{"key":"2023033021232476600_","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1093\/europace\/euw432","article-title":"Safety of fluoroscopy-guided transseptal approach for ablation of left-sided arrhythmias","volume":"19","author":"Matoshvili","year":"2017","journal-title":"Europace"},{"key":"2023033021232476600_","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1093\/europace\/euz042","article-title":"Chen M, Eckardt L, Long D et al. Inadvertent transseptal puncture into the aortic root: the narrow edge between luck and catastrophe in interventional cardiology","volume":"21","author":"Chen","year":"2019","journal-title":"Europace"},{"key":"2023033021232476600_","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1016\/j.jcin.2016.10.035","article-title":"Transseptal techniques for emerging structural heart interventions","volume":"9","author":"Alkhouli","year":"2016","journal-title":"JACC Cardiovasc Interv"},{"key":"2023033021232476600_","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/pace.13841","article-title":"Yasmeh B, Mitra R, Liu E et al. Safety and efficacy of zero fluoroscopy transseptal puncture with different approaches","volume":"43","author":"Baykaner","year":"2020","journal-title":"Pacing Clin Electrophysiol"},{"key":"2023033021232476600_","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1038\/nm1296-1393","article-title":". Nonfluoroscopic, in vivo navigation and mapping technology","volume":"2","author":"Ben-Haim","year":"1996","journal-title":"Nat Med"},{"key":"2023033021232476600_","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.ccep.2019.05.006","article-title":"Cardiac mapping systems: Rhythmia, Topera, EnSite Precision, and CARTO","volume":"11","author":"Borlich","year":"2019","journal-title":"Card Electrophysiol Clin"},{"key":"2023033021232476600_","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1111\/jce.12396","article-title":"Weber R, Schiebeling J, Allgeier J et al. Mechanisms of pulmonary vein reconnection after radiofrequency ablation of atrial fibrillation: the deterministic role of contact force and interlesion distance","volume":"25","author":"Park","year":"2014","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2023033021232476600_","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1093\/europace\/euaa034","article-title":"Allgeier HJ, Jadidi A, M\u00fcller-Edenborn B et al. 3D mapping for the identification of the fossa ovalis in left atrial ablation procedures: a pilot study of a first step towards an electroanatomic-guided transseptal puncture","volume":"22","author":"Eichenlaub","year":"2020","journal-title":"Europace"},{"key":"2023033021232476600_","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/jce.12356","article-title":"Park C Il, Schiebeling-R\u00f6mer J, Allgeier J et al. 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