Ultrasound-guided femoral venipuncture reduces complications in catheter ablation

Fewer major vascular complications after catheter ablation were reported in patients with atrial fibrillation (AF) when surgeons had used an ultrasound-guided vascular access strategy. Also, the number of surgical interventions for vascular complications was reduced in the ultrasound-guided patients compared with the non-ultrasound guided patients.

Dr Jana Haskova (Institute for Clinical and Experimental Medicine, Czechia) and colleagues conducted a retrospective study to analyse major vascular complications due to catheter ablation in patients with AF [1]. Included were 4,646 participants who underwent catheter ablation (mean age 61; 33% women), of whom 2,330 were operated on with an ultrasound-guided vascular access strategy. The other 2,316 participants were non-ultrasound guided historic controls. The primary outcome was the number of major complications, defined as complications that required surgery, led to prolonged hospital duration, resulted in re-hospitalisation, or were complications that consisted of significant haematoma/bleeding with a haemoglobin drop >30 g/L.

The rate of major vascular complications was significantly lower in the ultrasound-guided population than in the historic controls (1.38% vs 2.66%; P=0.003) (see Figure). Moreover, the number of major complications that required surgical intervention was reduced in the ultrasound-guided arm compared with the non-ultrasound-guided arm (0.26% vs 0.77%; P=0.02). Dr Haskova added that older age was associated with a higher complication rate (P=0.0002), whereas male sex was related to a lower complication rate (P=0.003).

Figure: Major vascular complications for ultrasound-guided and control participants [1]



 

 

 

 

 

 

 

 

 

 

Dr Haskova concluded: “An ultrasound-guided vascular access strategy was associated with a statistically significant reduction of major vascular complications after catheter ablation for AF. Therefore, the routine use of ultrasound guidance is recommended to improve the safety of venous vascular access in patients with AF who undergo ablation.”

1. Haskova J, et al. Ultrasound-guided femoral venipuncture for catheter ablation of atrial fibrillation: clinical benefit. Atrial fibrillation and ablation, EHRA 2022, 3–5 April, Copenhagen, Denmark.

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Posted on 1 June, 202213 June, 2022