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J Am Coll Cardiol. 2011 Jul 19;58(4):359-63. doi: 10.1016/j.jacc.2011.02.063.

Superiority of simulator-based training compared with conventional training methodologies in the performance of transseptal catheterization.

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Department of Heart, Brain and Vessels, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy.



This study aims to compare the performance of electrophysiology fellows in transseptal catheterization (TSP-C) after conventional (Conv-T) or simulator training (Sim-T).


Current training for TSP-C, an increasingly used procedure, relies on performance on patients with supervision by an experienced operator. Virtual reality, a new training option, could improve post-training performance.


Fellows inexperienced in TSP-C were enrolled and randomly assigned to Conv-T or Sim-T. The post-training performance of each fellow was evaluated and scored in 3 consecutive patient-based procedures by an experienced operator blinded to the fellow's training assignment.


Fourteen fellows were randomized to Conv-T (n = 7) or to Sim-T (n = 7) and, after training, performed 42 TSP-Cs independently. Training time was significantly longer for Conv-T than for Sim-T (median 30 days vs. 4 days; p = 0.0175). The Conv-T fellows had significantly lower post-training performance scores (median 68 vs. 95; p = 0.0001) and a higher number of recurrent errors (median 3 vs. 0; p = 0.0006) when compared with Sim-T fellows.


The TSP-C training with virtual reality results in shorter training times and superior post-training performance.

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