Adverse events
Major adverse events were defined as those causing termination of the procedure, prolonged hospital stay, long-term disability, requiring surgical intervention, CIED lead repositioning or bleeding requiring transfusion. In general, we focused on adverse events that could be directly attributed to TSP. Pericardial effusions occurring after completion of ablation procedures were not attributed to TSP. Periprocedural adverse events were monitored within 30-days of the ablation procedure. Cardiac perforation was suspected when the symptoms such as substernal discomfort, shoulder discomfort, abdominal discomfort, nausea, or clinical signs of hemodynamic instability were detected and pericardial effusion was confirmed with ICE or transthoracic echocardiogram. Pericardial effusion that necessitated intervention was defined as cardiac tamponade.