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

Objectives This study aims to compare the performance of electrophysiology fellows in transseptal catheterization (TSP-C)
after conventional (Conv-T) or simulator training (Sim-T).
Background 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.
Methods 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.
Results 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.
Conclusions The TSP-C training with virtual reality results in shorter training times and superior post-training
performance.