title: Superiority of simulator-based training compared with conventional training methodologies in the performance of transseptal catheterization.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Heart, Brain and Vessels, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: De Ponti
authors.forename: Raffaella
authors.initials: R
authors.lastname: Marazzi
authors.forename: Sergio
authors.initials: S
authors.lastname: Ghiringhelli
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Salerno-Uriarte
authors.forename: Hugh
authors.initials: H
authors.lastname: Calkins
authors.forename: Alan
authors.initials: A
authors.lastname: Cheng
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization / Q000379:methods*; D054849:Cardiac Electrophysiology / Q000193:education*; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male