{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:55:38Z","timestamp":1781672138921,"version":"3.54.5"},"reference-count":10,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T00:00:00Z","timestamp":1707350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pulsed field ablation (PFA) has emerged as an innovative technique for pulmonary vein isolation (PVI). Typically, a transeptal puncture (TSP) with a standard sheath precedes a switch to the larger diameter sheath in the left atrium. This study aimed to describe the safety and feasibility of direct TSP using the large diameter Faradrive sheath before performing PVI with PFA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively enrolled 166 consecutive patients with paroxysmal or persistent atrial fibrillation (AF) undergoing PVI with PFA at our institution. TSP was performed in all cases with transesophageal echocardiography guidance, using the Faradrive sheath and a 98\u2009cm matched Brockenbrough needle. The primary endpoint was the occurrence of pericardial tamponade during or within the first 48\u2009h after the procedure. The secondary endpoint was the occurrence of any major complication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 166 patients were included into the final analysis (44% female): 64% of patients had paroxysmal AF and 36% persistent AF (68\u2009\u00b1\u200911 years old, median CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>Vasc Score 3, median left atrial volume index 31). The median duration of the procedure was 60\u2009min, median time to TSP was 15\u2009min, and the median fluoroscopy dose was 595\u2009cGy\u2009\u00d7\u2009cm<jats:sup>2<\/jats:sup>. The primary endpoint occurred in one patient: a non\u2010TSP related pericardial tamponade, which was managed with pericardial puncture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Direct TSP with skipping sheath exchange using the large diameter Faradrive sheath for PVI with PFA was safe, feasible, and reduced costs in all patients. Large scale studies and registries are needed to verify this workflow.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16187","type":"journal-article","created":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T12:49:00Z","timestamp":1707396540000},"page":"688-693","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A zero\u2010exchange approach for left atrial access in pulmonary vein isolation with pulsed field ablation"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4820-3304","authenticated-orcid":false,"given":"Alexandru Gabriel","family":"Bejinariu","sequence":"first","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty Heinrich\u2010Heine University D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Spieker","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty Heinrich\u2010Heine University D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisaki","family":"Makimoto","sequence":"additional","affiliation":[{"name":"Data Science Center\/Cardiovascular Center Jichi Medical University Shimotsuke\u2010City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Augustin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty Heinrich\u2010Heine University D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malte","family":"Kelm","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty Heinrich\u2010Heine University D\u00fcsseldorf Germany"},{"name":"CARID, Cardiovascular Research Institute D\u00fcsseldorf, Medical Faculty Heinrich\u2010Heine\u2010University D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7956-3249","authenticated-orcid":false,"given":"Obaida R.","family":"Rana","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty Heinrich\u2010Heine University D\u00fcsseldorf Germany"},{"name":"CARID, Cardiovascular Research Institute D\u00fcsseldorf, Medical Faculty Heinrich\u2010Heine\u2010University D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2029980"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.15590"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12181-017-0179-4"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.121.010817"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-022-01294-x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrcr.2022.12.006"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euad060"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14899"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14903"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.16187","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T09:39:19Z","timestamp":1729762759000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.16187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,8]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/jce.16187"],"URL":"https:\/\/doi.org\/10.1111\/jce.16187","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,8]]},"assertion":[{"value":"2023-09-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}