Key result
Figure-of-eight sutures linked to ~28-minute shorter hemostasis time vs manual compression after AF ablation.
Why the study?
Does figure-of-eight suture reduce postprocedural recovery time compared to manual compression in patients undergoing AF ablation?
Cohort (n=104)
Does figure-of-eight suture reduce postprocedural recovery time compared to manual compression in patients undergoing AF ablation?
Figure-of-eight sutures provide efficient hemostasis and significantly reduce postprocedure recovery times, including time to hemostasis and extubation, compared to manual compression following AF ablation.
Answers are grounded in this paper and cite their sources.
Figure-of-eight sutures were associated with faster hemostasis after AF ablation; hypothesis-generating and requires randomized confirmation before practice change.
Background Ablation for atrial fibrillation (AF) requires multiple venous sheaths and anticoagulation with heparin, both risk factors for bleeding complications. Manual compression (MC) with heparin reversal is the standard method to achieve venous hemostasis postablation; however, temporary figure‐of‐eight sutures (F8S) are an alternative. While this technique has been shown to be safe and effective, little is known about its effect on postprocedural recovery time. Methods In this retrospective cohort study, consecutive patients who underwent AF radiofrequency ablation over a 23‐month period were reviewed for type of hemostasis (manual compression or figure‐of‐eight suture), demographics, periprocedural anticoagulation, groin complications, and procedural duration. Results A total of 104 patients were included (42 in the MC group and 62 in the F8S group). The two groups were similar for mean age, gender, weight, oral anticoagulant use, and procedural heparin dosing. Access site complications were 4.76% versus 3.23% (P = 0.68). Time from procedure end to sheath removal was lower in the F8S group (16.2 ± 8.47 vs 4.25 ± 4.14 min, P < 0.0001). Overall time from procedure end to hemostasis was 36.1 ± 10.1 min in the MC group versus 7.9 ± 5.6 in the F8S group (P < 0.0001). Times to extubation and transport out of the lab were both significantly lower in the F8S group (34.1 ± 14.6 vs 13.5 ± 5.4 min, and 44 ± 14.6 vs 21.9 ± 6.7 min, respectively, P < 0.0001). Conclusion Figure‐of‐eight sutures provided efficient hemostasis following AF ablation, with significantly reduced postprocedure recovery time including time to hemostasis, extubation, and transport out of the lab.
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Payne et al. (2018) conducted a cohort in Atrial fibrillation (n=104). Figure-of-eight sutures vs. Manual compression was evaluated on Overall time from procedure end to hemostasis (minutes) (p=<0.0001). Figure-of-eight sutures significantly reduced overall time from procedure end to hemostasis compared to manual compression (7.9 vs 36.1 min, P<0.0001) following AF ablation.
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