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ID: 4570818 MULTICENTER FIRST-IN-HUMAN EXPERIENCE OF A NOVEL RF TRANSSEPTAL GUIDEWIRE
Abstract   Open access   Peer reviewed

ID: 4570818 MULTICENTER FIRST-IN-HUMAN EXPERIENCE OF A NOVEL RF TRANSSEPTAL GUIDEWIRE

Devi G. Nair, Douglas N. Gibson, Mark D. Metzl, Usman Bhatti, Alex S. Ro, Nicholas Olson, Brandon Doty, Raymond N. Kawasaki, Vivek Y. Reddy, Maheer Gandhavadi, …
Heart rhythm O2, Vol.7(9), p.S7
09/2026
DOI: 10.1016/j.hroo.2026.08.012
url
https://doi.org/10.1016/j.hroo.2026.08.012View
Published (Version of record) Open Access

Abstract

Background Left atrial (LA) access is a critical step for many left-sided cardiac procedures. Traditional transseptal (TSP) techniques often require device exchanges, which can prolong procedure time and increase air embolism risk. The introduction of radiofrequency (RF)-powered TSP guidewires has been shown to reduce produce time and minimize or eliminate sheath exchanges. Objective Evaluate the safety and performance of a novel RF Guidewire for TSP in a multi-center experience. Methods A prospective analysis was performed in patients undergoing left atrial access using the RF guidewire (HOTWIRE; Atraverse Medical) used in conjunction with a standard electrosurgical generator (FT10; Medtronic). Procedures were guided by fluoroscopy and/or echocardiography, and introducer sheaths were used according to operator workflow preference. Endpoints were procedural success, occurrence of TSP-related adverse events, and TSP time, measured from femoral insertion to LA access. Results Between July 2024 and September 2025, 1,037 TSPs were completed in 1,020 patients by 29 operators across 11 institutions using 13 introducer sheaths. Procedural indications included 719 (70%) atrial fibrillation (AF) ablation, 141 (14%) left atrial appendage occlusion (LAAO), 116 (11%) concomitant, and 44 (4%) other. Procedural success was 100%, with a mean TSP time of 4.1 ± 3.8 minutes (95% CI: 3.88-4.34, p=0.0002). A zero-fluoroscopy approach was utilized in 296 procedures (29%). For 575 patients where data was available, 160 (28%) patients had undergone prior transseptal catheterization. No periprocedural adverse events leading to patient injury were reported. Conclusion This multicenter experience demonstrates the safety and performance of the HOTWIRE RF Guidewire for left heart access across a wide range of introducer sheaths, procedure workflows, allowing a zero-exchange workflow and procedures without radiation.

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