Evolution of Radiofrequency Transseptal Puncture Devices

Transseptal puncture (TSP) is an indispensable step for establishing left atrial access and plays a pivotal role in complex left-heart interventions, including catheter ablation for atrial fibrillation, left atrial appendage occlusion, and transcatheter mitral valve therapy. As such, TSP ranks among the core techniques in contemporary cardiovascular interventional cardiology. Since its first description in the 1950s, TSP tools have undergone decades of iterative refinement, evolving from conventional mechanical needles to diverse energy-assisted puncture systems. The performance of a TSP system directly determines procedural success, safety, and patient prognosis. This article systematically reviews the developmental history of TSP devices, with a focused overview of the developmental background, technical evolution, clinical applications, and advantages of radiofrequency-based puncture devices (including radiofrequency guidewires and radiofrequency needles), and briefly outlines future directions for innovation.