Journal
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
Volume 25, Issue 7, Pages 680-685Publisher
WILEY
DOI: 10.1111/jce.12404
Keywords
atrial fibrillation; catheter ablation; complications; ultrasound; vascular complications
Categories
Funding
- Sonosite UK
- Biosense Webster
- Sanofi Aventis
- Boehringer Ingelheim
- Medtronic
- Boston Scientific
- St. Jude Medical
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Vascular Ultrasound for AFA. Introduction: The most frequent complications of AF ablation (AFA) are related to vascular access, but there is little evidence as to how these can be minimized. Methods: Consecutive patients undergoing AFA at a high-volume center received either standard care (Group S) or routine ultrasound-guided vascular access (Group U). Vascular complications were assessed before hospital discharge and by means of postal questionnaire 1 month later. Outcome measures were BARC 2+ bleeding complications, postprocedural pain, and prolonged bruising. Results: Patients in Group S (n = 146) and U (n = 163) were well matched at baseline. Follow-up questionnaires were received from 92.6%. Patients in Group U were significantly less likely to have a BARC 2+ bleed, 10.4% versus 19.9% P = 0.02, were less likely to suffer groin pain after discharge (27.1% vs. 42.8%; P = 0.006) and were less likely to experience prolonged local bruising (21.5% vs. 40.4%; P = 0.001). Multivariable logistic regression analysis revealed a significant association of vascular complications with nonultrasound guided access (OR 3.12 95% CI 1.54-5.34; P = 0.003) and increasing age (OR 1.05 95% CI 1.01-1.09; P = 0.02). Conclusion: Routine use of ultrasound-guided vascular access for AFA is associated with a significant reduction in bleeding complications, postprocedural pain, and prolonged bruising when compared to standard care.
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