Improving Safety in Catheter Ablation for Atrial Fibrillation: A Prospective Study of the Use of Ultrasound to Guide Vascular Access. (2nd April 2014)

• Record Type: Journal Article
• Authors: WYNN, GARETH J.; HAQ, IRAM; HUNG, JOHN; BONNETT, LAURA J.; LEWIS, GAVIN; WEBBER, MATTHEW; WAKTARE, JOHAN E.P.; MODI, SIMON; SNOWDON, RICHARD L.; HALL, MARK C.S.; TODD, DERICK M.; GUPTA, DHIRAJ
• Is Part Of: Journal of cardiovascular electrophysiology. Volume 25:Number 7(2014:Jul.)
• Page Start: 680
• Page End: 685
• Publication Date: 2014-04-02
• Subjects: Blood vessels -- Physiology -- Periodicals; Electrophysiology -- Periodicals; Heart -- Physiology -- Periodicals; 612.1
• DOI: 10.1111/jce.12404
• Languages: English
• ISSNs: 1045-3873

Abstract

<abstract abstract-type="main"> <title>Vascular Ultrasound for AFA</title> <sec id="jce12404-sec-0010" sec-type="section"> <title>Introduction</title> <p>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.</p> </sec> <sec id="jce12404-sec-0020" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="jce12404-sec-0030" sec-type="section"> <title>Results</title> <p>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).</p> </sec> <sec id="jce12404-sec-0040" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>