Evidence map›Paper›PMID 39989365›Full record

Trial reportCirculation2025

Left Ventricular Entry to Reduce Brain Lesions During Catheter Ablation: A Randomized Trial.

Gregory M Marcus, Roderick Tung, Edward P Gerstenfeld, Trisha F Hue, Feng Lin, Jing Cheng, J Peter Weiss, Wendy S Tzou, Henry Hsia, Ashkan Ehdaie and 25 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03946072 (Multi-center Comparative Effectiveness Randomized Trial to Assess a Transseptal Approach to Left Ventricular Ablation Compared to Retrograde to Prevent Cerebral Emboli & Neurocognitive Decline in Adults With Ventricular Tachycardia/Premature Ventricular Contractions), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03946072 nacompletednot on this map

Multi-center Comparative Effectiveness Randomized Trial to Assess a Transseptal Approach to Left Ventricular Ablation Compared to Retrograde to Prevent Cerebral Emboli & Neurocognitive Decline in Adults With Ventricular Tachycardia/Premature Ventricular Contractions

TypeinterventionalSponsorUniversity of California, San FranciscoRan2019 to 2023Enrolled153ConditionsNeurocognitive DysfunctionArmsTransseptal Aortic Approach Catheter Ablation Procedure, Retrograde Aortic Approach Catheter Ablation Procedure
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
  4. Management of Idiopathic Outflow Tract Ventricular Arrhythmias.Arrhythmia & electrophysiology review · 2026
    Review
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

35 authors.

Gregory M MarcusDivision of Cardiology (G.M.M., E.P.G., H.H., A.L., J.M., G.W., K.C., M.Y., G.M.), University of California, San Francisco.ORCID 0000-0001-5197-7696
Roderick TungDivision of Cardiology (G.M.M., E.P.G., H.H., A.L., J.M., G.W., K.C., M.Y., G.M.), University of California, San Francisco.ORCID 0000-0002-8513-1303
Edward P GerstenfeldDivision of Cardiology (G.M.M., E.P.G., H.H., A.L., J.M., G.W., K.C., M.Y., G.M.), University of California, San Francisco.ORCID 0000-0002-7200-3521
Trisha F HueDepartment of Epidemiology and Biostatistics (T.F.H., F.L.), University of California, San Francisco.ORCID 0000-0001-5922-5755
Feng LinDepartment of Epidemiology and Biostatistics (T.F.H., F.L.), University of California, San Francisco.
Jing ChengOral Epidemiology & Dental Public Health (J.C.), University of California, San Francisco.ORCID 0000-0002-0417-3713
J Peter WeissDivision of Cardiology, University of Arizona College of Medicine-Phoenix, Banner - University Medical Center (R.T., J.P.W.).ORCID 0000-0002-1228-2581
Wendy S TzouDivision of Cardiology, University of Colorado Anschutz Medical Center, Aurora (W.S.T.).ORCID 0000-0002-8514-1165
Henry HsiaDivision of Cardiology (G.M.M., E.P.G., H.H., A.L., J.M., G.W., K.C., M.Y., G.M.), University of California, San Francisco.ORCID 0000-0001-8187-9755
Ashkan EhdaieDivision of Cardiology (G.M.M., E.P.G., H.H., A.L., J.M., G.W., K.C., M.Y., G.M.), University of California, San Francisco.ORCID 0000-0003-0097-0026
Daniel H CooperCardiovascular Division, Washington University School of Medicine, St. Louis (D.H.C.).ORCID 0009-0001-6017-6855
T Jared BunchDivision of Cardiovascular Medicine, University of Utah, Salt Lake City (T.J.B.).ORCID 0000-0001-5349-0136
Jeffrey ArklesCardiovascular Division, University of Pennsylvania, Philadelphia (J.A.).
Babak NazerDivision of Cardiology, University of Washington, Seattle (B.N.).ORCID 0000-0002-4078-9064
Adam LeeDivision of Cardiology (G.M.M., E.P.G., H.H., A.L., J.M., G.W., K.C., M.Y., G.M.), University of California, San Francisco.ORCID 0000-0002-0189-171X
Alexios HadjisDivision of Cardiology, Hôpital du Sacré-Coeur de Montréal, University of Montreal, Canada (A.H.).ORCID 0000-0003-3094-1648
Duy T NguyenDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (D.T.N.).
Mihail G CheluDepartment of Medicine-Cardiology, Cardiovascular Research Institute, Baylor College of Medicine and Texas Heart Institute at Baylor St. Luke's Medical Center, Houston (M.G.C.).ORCID 0000-0001-9688-1604
Joshua MossDivision of Cardiology (G.M.M., E.P.G., H.H., A.L., J.M., G.W., K.C., M.Y., G.M.), University of California, San Francisco.
Jonathan C HsuDivision of Cardiology, University of California, San Diego (J.C.H.).ORCID 0000-0002-1523-573X
Miguel ValderrábanoDepartment of Cardiology, Houston Methodist Hospital, TX (M.V.).ORCID 0000-0002-8401-1684
Prashant D BhaveDepartment of Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, NC (P.D.B.).ORCID 0000-0003-0664-7828
Andrew D BeaserSection of Cardiology, University of Chicago, IL (A.D.B.).ORCID 0000-0001-7624-742X
Arvindh KanagasundramDivision of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (A.K.).ORCID 0000-0001-8295-1528
Oussama WazniDepartment of Cardiovascular Medicine, Cleveland Clinic, OH (O.W.).ORCID 0000-0001-7115-7716
Jason BradfieldCardiac Arrhythmia Center, University of California, Los Angeles (J.B.).
Grace WallDivision of Cardiology (G.M.M., E.P.G., H.H., A.L., J.M., G.W., K.C., M.Y., G.M.), University of California, San Francisco.
Kathleen ChangDivision of Cardiology (G.M.M., E.P.G., H.H., A.L., J.M., G.W., K.C., M.Y., G.M.), University of California, San Francisco.ORCID 0000-0001-6321-3618
Michelle YangDivision of Cardiology (G.M.M., E.P.G., H.H., A.L., J.M., G.W., K.C., M.Y., G.M.), University of California, San Francisco.
Gabrielle MontenegroDivision of Cardiology (G.M.M., E.P.G., H.H., A.L., J.M., G.W., K.C., M.Y., G.M.), University of California, San Francisco.
Sabrina JarrottDepartment of Neurology (S.J., J.H.K., A.S.K.), University of California, San Francisco.ORCID 0009-0003-6299-3140
Joel H KramerDepartment of Neurology (S.J., J.H.K., A.S.K.), University of California, San Francisco.
Anthony S KimDepartment of Neurology (S.J., J.H.K., A.S.K.), University of California, San Francisco.ORCID 0000-0002-8095-6517
Yvonne M MorrisPatient Author (Y.M.M.), University of California, San Francisco.
William P DillonDepartment of Radiology and Biomedical Imaging (W.P.D.), University of California, San Francisco.ORCID 0000-0002-7222-4615

Funding

Mechanisms of Lamin A/C-mediated Cardiac Conduction DisordersR01HL166832 · BAYLOR COLLEGE OF MEDICINE · 2025 to 2025
$609k
NHLBI NIH HHS R01 HL166832Patient-Centered Outcomes Research Institute CER-2017C3-9091
6 · The paper itself

Abstract

backgroundCatheter ablation of ventricular arrhythmias, one of the most rapidly growing procedures in cardiac electrophysiology, is associated with magnetic resonance imaging-detected brain lesions in more than half of cases. Although a retrograde aortic approach is conventional, modern tools enable entry through a transseptal approach that may avoid embolization of debris from the arterial system. We sought to test the hypothesis that a transseptal puncture would mitigate brain injury compared with a retrograde aortic approach.

methodsThe TRAVERSE trial (Transseptal Versus Retrograde Aortic Ventricular Entry to Reduce Systemic Emboli) was a multicenter randomized controlled comparative effectiveness trial. Patients with left ventricular arrhythmias undergoing catheter ablation procedures were randomly assigned to a transseptal puncture approach compared (1:1) with a retrograde aortic approach. The primary outcome was the presence of an acute brain lesion detected by magnetic resonance imaging. Secondary outcomes included clinically manifest complications, procedural efficacy, and 6-month neurocognitive assessments.

resultsAmong the 62 patients randomly assigned to a retrograde aortic approach with postoperative brain magnetic resonance imaging, 28 (45%) exhibited an acute brain lesion compared with 19 of the 69 (28%) of those randomized to a transseptal puncture (

conclusionsAmong patients undergoing left ventricular catheter ablation procedures, a transseptal approach reduced the risk of acute brain lesions by nearly half compared with a retrograde aortic approach without sacrificing safety or efficacy. Given a likely embolic pathogenesis, the brain magnetic resonance imaging findings may reflect a propensity to other organ damage; these findings may extend to other procedures requiring left ventricular entry. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03946072.

Indexed as

Catheter AblationHeart VentriclesAgedFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedTreatment Outcomearrhythmias, cardiacbrain injuriescatheter ablationelectrophysiologic techniques, cardiacembolismfollow-up studiesmagnetic resonance imaging

Identifiers

PMID39989365
PMCPMC12375378

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.