Optimising the atrial fibrillation ablation pathway using vascular closure devices: effects on length of stay, procedure time and outcomes

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Atrial fibrillation (n=159). Intervention: Suture-mediated closure devices (Perclose ProGlide) vs. Manual compression. Primary outcome: Hospitalisation duration (hours) (3.7-hour reduction, p=<0.001).

Q: What does this research mean for the field?

Suture-mediated vascular closure devices significantly reduce hospital stay, procedure time, and post-procedure bed rest compared to manual compression in adults undergoing catheter ablation for atrial fibrillation, without increasing complications. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the impact of vascular closure devices on hospital stay, patient experience, staff workload, and costs within the care pathway following catheter ablation for atrial fibrillation.

Miriam A Scheurwater; Bianca de Louw; Dennis van Veghel; Daniela N Schulz; Alexandre J. Ouss; Rolf P. J. de Bruin; L R C Dekker

doi:10.1007/s12471-026-02020-2

March 3, 2026Netherlands Heart JournalOpen Access

Optimising the atrial fibrillation ablation pathway using vascular closure devices: effects on length of stay, procedure time and outcomes

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Key result

Suture-mediated closure devices linked to ~4-hour shorter stay vs manual compression in AF ablation.

3.7-hour reduction
P<0.001
n=159

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Why the study?

The rising prevalence of atrial fibrillation has increased pulmonary vein isolations, necessitating optimisation of care pathway efficiency after catheter ablation.

Does the use of suture-mediated vascular closure devices improve hospitalisation duration and patient experience compared to manual compression in patients undergoing catheter ablation for atrial fibrillation?

Key Points

To evaluate the impact of vascular closure devices on hospital stay, patient experience, staff workload, and costs within the care pathway following catheter ablation for atrial fibrillation.
Compared a standard care pathway using manual compression (MC, n=81, December 2023–February 2024) to an optimized pathway using suture-mediated closure devices (CD, n=78, March–May 2024) in 159 patients undergoing catheter ablation.
Assessed process indicators (hospital stay duration, procedure time, post-procedure bed rest), clinical safety (bleeding and general complications), patient-reported pain, staff feedback from 24 nurses, and procedural healthcare costs.
Hospitalization duration decreased from a median of 11.6 hours (IQR 11.1–12.9) in the MC group to 7.9 hours (IQR 6.9–9.6) in the CD group (p < 0.001), bed rest fell from 6.0 hours to 2.0 hours (IQR 2.0–2.5; p < 0.001), and procedure time shortened from 77.0 minutes to 67.5 minutes (p = 0.006).
Patients in the CD group reported lower median pain scores (1 vs 3, p = 0.001), required less pain medication (7.7% vs 23.5%, p = 0.006), and felt more comfortable with discharge (96.2% vs 82.7%, p = 0.009).
Total bleeding complications did not differ significantly between groups (20.5% with CD vs 29.6% with MC, p = 0.185), and average overall costs per patient remained similar (€11,679.19 vs €11,763.89).

Study Design

Type

Observational (n=159)

Multicenter

No

Structured PICO

Does the use of suture-mediated vascular closure devices improve hospitalisation duration and patient experience compared to manual compression in patients undergoing catheter ablation for atrial fibrillation?

P

Population

159 adults with atrial fibrillation undergoing catheter ablation were evaluated to compare a modified care pathway using vascular closure devices against standard manual compression.

I

Intervention

Suture-mediated vascular closure device (two devices per patient) followed by 2 hours of bed rest and 1 hour of observation.

C

Comparator

Manual compression followed by 6 hours of pressure bandaging and bed rest, and 2 hours of observation.

O

Outcome

Process indicators (hospitalisation duration, procedure time, post-procedure bed rest, unplanned overnight stays, and pain medication use) and patient experience (pain ratings, pain-related complaints, and other complaints).patient reported

Main Result

Effect estimate: 3.7-hour reduction

Absolute Event Rate: 7.9% vs 11.6%

p-value: p=<0.001

The use of vascular closure devices after atrial fibrillation ablation significantly reduces hospital stay and improves patient comfort without increasing costs or complications.

Limitations

Retrospective data analysis
Patient-reported outcomes may have been influenced by response bias as nurses informed patients that closure devices represent a care innovation
Cost analysis used national hospitalisation costs and excluded potential revenue from increased procedural capacity
Potential response bias in patient-reported outcomes as nurses informed patients that closure devices represent a care innovation
Cost analysis excluded potential revenue from increased procedural capacity

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Answers are grounded in this paper and cite their sources.

Implication

May support expedited discharge after AF ablation; leaves open confirmation in randomized trials.

Abstract

BACKGROUND: The rising prevalence of atrial fibrillation has led to increasing the numbers of pulmonary vein isolations. Optimising care pathway efficiency is essential for sustainable healthcare delivery. This study aimed to evaluate the impact of closure devices (CD) within the care pathway on hospital stay, patient satisfaction, staff workload, and costs, following catheter ablation for atrial fibrillation. METHODS: This study compared the standard care pathway following catheter ablation using manual compression (MC, December 2023-February 2024) to a modified pathway incorporating suture-mediated CD (March-May 2024). Primary outcomes included process indicators (e.g., hospitalisation duration), clinical outcomes (e.g., bleeding complications), and patient experience. Secondary outcomes included staff experience and healthcare costs associated with procedural changes. RESULTS: A total of 159 patients participated (MC: 81 patients, CD: 78 patients). Patients received an average of 2 percutaneous sutures. Treatment with CDs resulted in a 3.7-hour reduction in hospitalisation duration (p <. 001), 10-minute shorter procedure time in first-time ablations (p = .006), and 4‑hour shorter bed rest (p <. 001). Patients experienced less pain, measured using the Numeric Rating Scale (median 3 vs 1, p = .001), and used less pain medication (p = .006). Discharge comfort was higher in the CD group (p = .009), while complication rates remained similar. 24 nurses participated in the questionnaire. Most nurses reported improved time efficiency and workday organisation. Costs were similar across groups. CONCLUSION: CDs improve care pathways after atrial fibrillation ablation by reducing hospitalisation time, enhancing patient comfort, and improving workflow efficiency without increasing complications.

Discussion

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Cite This Study

Scheurwater et al. (2026) conducted an observational in Atrial fibrillation (n=159). Suture-mediated closure devices (Perclose ProGlide) vs. Manual compression was evaluated on Hospitalisation duration (hours) (3.7-hour reduction, p=<0.001).

synapsesocial.com/papers/69a91d7cd6127c7a504c0405 https://doi.org/10.1007/s12471-026-02020-2

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Optimising the atrial fibrillation ablation pathway using vascular closure devices: effects on length of stay, procedure time and outcomes

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Optimising the atrial fibrillation ablation pathway using vascular closure devices: effects on length of stay, procedure time and outcomes

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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