Figure-of-8 Suture With a 3-Way Tap Versus Manual Compression After Atrial Fibrillation Ablation

Q: What are the key findings of this study?

Figure-of-8 suture with a 3-way tap was superior to manual compression for access site complications, but a 2-hour bed rest strategy failed to meet noninferiority criteria versus 4 hours.

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Atrial Fibrillation. Intervention: Figure-of-8 Suture With a 3-Way Tap (Fo8TAP) vs. Manual compression (MC). Primary outcome: any access site complication before hospital discharge.

Q: What does this research mean for the field?

Figure-of-8 suture with a 3-way tap reduces the incidence of access site complications after atrial fibrillation catheter ablation compared to manual compression. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Mark T. Mills; Peter Calvert; Laurence Tidbury; Keith Wilson; Thomas Rhys Evans; Luca De Francesco; Aurélie Najm; Rajiv Tripathi; Jose Maria Farinha; Panagiotis Xydis; Kaung Thu; Richard Snowdon; Zoltan Borbas; Johan Waktare; Saagar Mahida; Nathan Denham; Reza Ashrafi; Derick Todd; Simon S. Modi; Vishal Luther; Dhiraj Gupta

doi:10.1016/j.jacep.2026.01.014

Key result

Figure-of-8 suture with 3-way tap reduces access site complications vs manual compression after AF ablation.

Graphical abstract published by JACC. Clinical electrophysiology — Graphical abstract · Published by JACC. Clinical electrophysiology · CC BY 4.0

Why the study?

Does Figure-of-8 Suture With a 3-Way Tap reduce access site complications in patients undergoing atrial fibrillation catheter ablation?

Key Points

To assess the efficacy of figure-of-8 suture with a 3-way tap (Fo8TAP) compared with manual compression, and to test whether post-procedure bed rest could be shortened from 4 hours to 2 hours.
In the randomized controlled HARNESS trial (NCT06470555), patients undergoing venous access for atrial fibrillation catheter ablation were assigned to manual compression with 4-hour bed rest (MC-4), Fo8TAP with 4-hour bed rest (TAP-4), or Fo8TAP with 2-hour bed rest (TAP-2).
The primary endpoint was any access-site complication prior to discharge, tested for superiority (TAP-4 vs MC-4) and noninferiority (TAP-2 vs TAP-4); secondary endpoints included time to hemostasis and time to mobilization.
Fo8TAP demonstrated superiority over manual compression in reducing access-site complications before hospital discharge; however, a 2-hour bed rest duration (TAP-2) failed to establish noninferiority compared with 4 hours (TAP-4).
Time to hemostasis was significantly lower with suture closure than manual compression (MC-4: 16 min vs TAP-4: 9 min vs TAP-2: 8 min; P < 0.001).
Median time to mobilization was significantly reduced with the 2-hour protocol compared to 4-hour rest (TAP-2: 122 min vs TAP-4: 241 min vs MC-4: 242 min; P < 0.001).

Study Design

Type

RCT

Structured PICO

Does Figure-of-8 Suture With a 3-Way Tap reduce access site complications in patients undergoing atrial fibrillation catheter ablation?

P

Population

Patients undergoing atrial fibrillation catheter ablation

I

Intervention

Figure-of-8 Suture With a 3-Way Tap (Fo8TAP) with 4-hour bed rest (TAP-4) or 2-hour bed rest (TAP-2)

C

Comparator

Manual compression with 4-hour bed rest (MC-4)

O

Outcome

Any access site complication before hospital dischargesafety

Figure-of-8 suture with a 3-way tap reduces access site complications compared to manual compression after AF ablation, but requires 4 hours of bed rest rather than 2 hours.

Implication

Supports figure-of-8 suture with 3-way tap after AF ablation to cut complications; extends RCT evidence for vascular closure techniques.

Abstract

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Discussion

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Cite This Study

Mills et al. (2026) conducted an RCT in Atrial Fibrillation. Figure-of-8 Suture With a 3-Way Tap (Fo8TAP) vs. Manual compression (MC) was evaluated on any access site complication before hospital discharge. Figure-of-8 suture with a 3-way tap was superior to manual compression for access site complications, but a 2-hour bed rest strategy failed to meet noninferiority criteria versus 4 hours.

synapsesocial.com/papers/699a9ca1482488d673cd25be https://doi.org/10.1016/j.jacep.2026.01.014

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Figure-of-8 Suture With a 3-Way Tap Versus Manual Compression After Atrial Fibrillation Ablation

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Cite This Study

Figure-of-8 Suture With a 3-Way Tap Versus Manual Compression After Atrial Fibrillation Ablation

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Cite This Study

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