Academic Journal
The impact of ultrasound-guided vascular access for catheter ablation of left atrial arrhythmias in a high-volume centre
| Title: | The impact of ultrasound-guided vascular access for catheter ablation of left atrial arrhythmias in a high-volume centre |
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| Authors: | Amelie Krimphoff, Lukas Urbanek, Stefano Bordignon, David Schaack, Shota Tohoku, Shaojie Chen, K. R. Julian Chun, Boris Schmidt |
| Source: | J Interv Card Electrophysiol |
| Publisher Information: | Springer Science and Business Media LLC, 2024. |
| Publication Year: | 2024 |
| Subject Terms: | Male, Incidence, Female [MeSH], Aged [MeSH], Humans [MeSH], Prospective Studies [MeSH], Ultrasonography, Interventional/methods [MeSH], Treatment Outcome [MeSH], Catheter ablation, Incidence [MeSH], Postoperative Complications/epidemiology [MeSH], Catheter Ablation/methods [MeSH], Middle Aged [MeSH], Atrial fibrillation, Punctures [MeSH], Hospitals, High-Volume [MeSH], Atrial Fibrillation/diagnostic imaging [MeSH], Article, Atrial Fibrillation/surgery [MeSH], Male [MeSH], Vascular access complications, Ultrasound-guided vascular access, Atrial arrhythmias, Punctures, Middle Aged, 03 medical and health sciences, Treatment Outcome, Postoperative Complications, 0302 clinical medicine, Atrial Fibrillation, Catheter Ablation, Humans, Female, Prospective Studies, Ultrasonography, Interventional, Hospitals, High-Volume, Aged |
| Description: | Background Vascular complications are a common occurrence during atrial fibrillation ablation. Observational studies indicate that the utilization of ultrasound (US)-guided puncture may decrease the incidence of vascular complications; however, its routine use is not established in many centres. Methods Patients undergoing catheter ablation for atrial fibrillation were included sequentially. All patients receiving US-guided punctures were prospectively enrolled (US group), while patients who underwent the procedure with standard puncture technique served as control group (No-US group). Periprocedural vascular complications requiring intervention within 30 days of the procedure were defined as the primary endpoint. Results A total of 599 patients (average age: 69 ± 11 years, 62.9% male) were analysed. The incidence of vascular complications was lower with the US-guided puncture than with the anatomic landmark-guided puncture (14/299 [4.7%] vs. 27/300 [9%], p = 0.036). The US-guided vascular access significantly reduced the rate of false aneurysms (3/299 [1%] vs. 12/300 [4%], p = 0.019). In addition, the occurrence of arteriovenous fistula (2/299 [0.7%] vs. 4/300 [1.3%], p = 0.686) and haematoma requiring treatment (9/299 [3%] vs. 11/300 [3.7%], p = 0.655) were also lower in the US group. US-guided puncture did not prolong the procedure time (mean procedure time: 57.48 ± 24.47 min vs. 56.09 ± 23.36 min, p = 0.478). Multivariate regression analysis identified female gender (OR 2.079, CI 95% 1.096–3.945, p = 0.025) and conventional vascular access (OR 2.079, CI 95% 1.025–3.908, p = 0.042) as predictors of vascular complications. Conclusions The implementation of US-guided vascular access for left atrial catheter ablation resulted in a significant decrease of the overall vascular complication rate. |
| Document Type: | Article Other literature type |
| Language: | English |
| ISSN: | 1572-8595 |
| DOI: | 10.1007/s10840-024-01779-x |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/38573537 https://repository.publisso.de/resource/frl:6508929 |
| Rights: | CC BY |
| Accession Number: | edsair.doi.dedup.....7e4ba78031ed9e35e4deabdf7dc3f79c |
| Database: | OpenAIRE |
| ISSN: | 15728595 |
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| DOI: | 10.1007/s10840-024-01779-x |