Adverse events
Overall procedural complication rate was 1.9% (11/586 procedures). We registered 6 pericardial effusions that occurred after the completion of CA procedures and resolved spontaneously, causing only prolonged hospital stay. These pericardial effusions could not be attributed to TSP. Also, there were two femoral artery pseudoaneurysms requiring surgical intervention and one transient phrenic nerve palsy causing disability during the six-month recovery period. Detailed information on adverse events is provided in Table 3.
Importantly, adverse event rate that could be unequivocally attributed to the transseptal access was only 0.3% (3/949). Of note, one transseptal access related adverse event was CIED ventricular lead dislocation. Lead repositioning was performed during the same hospitalization. There was only 1 pericardial tamponade requiring intervention recorded immediately after double TSP was performed (2/949, 0.2%). Since this was a double transseptal puncture and it was not clear which of the punctures resulted in tamponade, both were registered as adverse events. The cause for tamponade in this case was probably inadvertent puncture of the opposite left atrial wall during advancement of the transseptal needle in the presence of a small left atrium and a floppy interatrial septum.