{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T14:53:31Z","timestamp":1781535211111,"version":"3.54.5"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transseptal puncture (TSP) is essential for various structural and electrophysiological cardiac procedures. However, the conventional mechanical needle can be challenging in complex anatomies. Radiofrequency (RF)\u2010assisted puncture systems offer an alternative to facilitate septal crossing and potentially reduce complications. This study aimed to evaluate the efficacy and safety of RF needle TSP compared with the conventional mechanical approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      A systematic review and meta\u2010analysis was conducted following PRISMA guidelines (PROSPERO: CRD420251272470). Primary efficacy outcomes included unassisted success, crossover, and TSP and fluoroscopy time, failure to obtain left atrial access, while safety outcomes included pericardial effusion or cardiac tamponade. Statistical analyses were conducted in R software (version 4.5.1) risk ratios (RR) and differences (MD), and heterogeneity was assessed by\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This review included nine studies, amongst them randomized and nonrandomized. The RF needle demonstrated statistically significant superiority in several efficacy outcomes: increased unassisted success (RR: 1.05; 95% CI: 1.01\u20131.10), marked reduction risk in crossover rate (RR: 0.11; 95% CI: 0.03\u20130.38), and failure to obtain transseptal access (RR: 0.11; 95% CI: 0.04\u20130.33). Furthermore, the RF technique significantly reduced TSP time (MD: \u2212154.7 s) and fluoroscopy time (MD: \u201384.5 s). Successful TSP rates (RR: 1.03; 95% CI: 0.99\u20131.06) and pericardial effusion or cardiac tamponade (RR: 0.55; 95% CI: 0.12\u20132.57) were comparable between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RF\u2010assisted TSP demonstrated superior performance compared with the conventional mechanical technique, offering higher unassisted primary efficacy, reducing access failures, and improving procedural efficiency. Although major complication rates are similar, RF may be considered a preferred strategy, especially in complex anatomies, due to its predictability and potential benefit in neurological safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70214","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T04:55:01Z","timestamp":1774673701000},"page":"742-752","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiofrequency Needle and Conventional Mechanical Needle for Transseptal Access: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2679-2232","authenticated-orcid":false,"given":"Samuel Oliveira","family":"de Amorim","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of the State of Par\u00e1 (UEPA)  Santar\u00e9m Par\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1931-015X","authenticated-orcid":false,"given":"Matheus da Silva","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of the State of Par\u00e1 (UEPA)  Santar\u00e9m Par\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4476-2357","authenticated-orcid":false,"given":"Cid","family":"Soares","sequence":"additional","affiliation":[{"name":"Faculty of Medicine UniAtenas  Passos Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vit\u00f3ria Caroline Lopes","family":"Bastos","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Amazon University Center (UNAMA)  Santar\u00e9m Par\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Fernanda Matos","family":"Aires","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Amazon University Center (UNAMA)  Santar\u00e9m Par\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6483-7991","authenticated-orcid":false,"given":"Felipe Henrique Lima","family":"Pereira","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of the State of Par\u00e1 (UEPA)  Santar\u00e9m Par\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan Fellipe Cardoso","family":"da Silva","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of the State of Par\u00e1 (UEPA)  Santar\u00e9m Par\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1607-9976","authenticated-orcid":false,"given":"Jos\u00e9 Alexandre","family":"Neto","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of the State of Par\u00e1 (UEPA)  Santar\u00e9m Par\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9700-9938","authenticated-orcid":false,"given":"Marcos Manoel","family":"Honorato","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of the State of Par\u00e1 (UEPA)  Santar\u00e9m Par\u00e1 Brazil"},{"name":"Faculty of Medicine Amazon University Center (UNAMA)  Santar\u00e9m Par\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.10.035"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(59)90347-9"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.01.061"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-011-9564-2"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000428"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.04.032"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-019-00608-w"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.shj.2023.100203"},{"issue":"1","key":"e_1_2_13_10_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2018-000858","article-title":"Synthesising Quantitative Evidence in Systematic Reviews of Complex Health Interventions","volume":"4","author":"Higgins J. 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