{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T21:21:14Z","timestamp":1762377674308,"version":"3.38.0"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81970273"],"award-info":[{"award-number":["81970273"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Transseptal catheterization is critical for atrial fibrillation (AF) ablation but risks thromboembolism. Transseptal sheaths (TSS) were suggested for continuous heparinized saline solution flush. The safety and effectiveness of a simple TSS management to reduce sheath\u2010associated thrombus development risk was investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>AF patients who underwent radiofrequency ablation with the simple TSS management were studied under a retrospective multi\u2010center observation study and a prospective single\u2010center observation study. TSS and dilators were washed and perfused with high concentration heparinized saline (20\u00a0u\/mL). Immediately after two successful transseptal punctures, activated clotting time \u2265300\u00a0s was maintained by heparin infusion. TSS aspiration with negative suction and re\u2010perfusion with high concentration heparinized saline (20\u00a0u\/mL) was performed for the remaining procedure before and after catheter withdrawal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 4765 AF patients underwent 5367 ablation procedures were enrolled in the retrospective study, involving 156 (2.9% per procedure) complications. No acute stroke occurred during all the procedures. Perioperative thromboembolic complications occurred in 10 (0.21%) patients and in 10 (0.19%) procedures. Thromboembolic complications occurred within 24 h, between 24\u201348 h, and after 48 h post\u2010procedure in six, two, and two patients, respectively. In the prospective observation study, neither sheath\u2010 nor catheter\u2010associated thrombus were detected by the intracardiac echocardiography during all 127 procedures, without any perioperative thromboembolic complications. No hemorrhagic cerebrovascular complication was encountered in both observational studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For AF radiofrequency ablation, it was safe and effective for TSS high concentration heparinized saline infusion only. This approach could avoid sheath\u2010associated thrombus for interventional procedures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.15115","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T08:52:01Z","timestamp":1733820721000},"page":"334-342","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Transseptal Sheath Perfused With High Concentration Heparinized Saline for Reducing Sheath\u2010Associated Thrombus"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2122-6469","authenticated-orcid":false,"given":"Juan","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Cardiology Shanghai General Hospital Shanghai Jiao Tong University, School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Cardiology Shanghai General Hospital Shanghai Jiao Tong University, School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3490-2523","authenticated-orcid":false,"given":"Yuanjun","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Dalian Medical University  Dalian Liaoning China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenning","family":"Nie","sequence":"additional","affiliation":[{"name":"Department of Cardiology Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya","family":"Zhen","sequence":"additional","affiliation":[{"name":"Department of Cardiology The Affiliated Hospital of Jiangsu University  Zhenjiang Jiangsu 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