Ultrasound-guided venipuncture was associated with a near-to-zero risk of major clinical vascular complications compared to no ultrasound guidance (0% vs 1.7%, P=0.02) during cryoballoon ablation.
Cohort (n=1,435)
Yes
Does ultrasound-guided venipuncture and post-procedural evaluation reduce vascular complications in patients undergoing cryoballoon ablation for atrial fibrillation?
Routine use of ultrasound for venous access guidance during AF cryoballoon ablation significantly reduces vascular complications to near zero.
Absolute Event Rate: 0% vs 1.7%
p-value: p=0.02
AIMS: Vascular complications are the most common complications of atrial fibrillation (AF) ablation. Cryoballoon (CB) ablation for AF needs the insertion of a large 15 Fr sheath in the femoral vein. Our aim was to investigate the impact of vascular ultrasound (US) in guiding access and evaluating post-procedural subclinical complications in a large, multi-centre patient cohort that underwent CB ablation. METHODS AND RESULTS: A total cohort of 1435 consecutive patients were subdivided in 870 US -/-, 265 US -/+, and 300 US +/+ patients depending on US performance for: venipuncture guidance/post-procedural evaluation. Major clinical complications (requiring intervention and/or prolonged stay) were assessed. Irrespective of the clinical status, major US events were systematically determined in the subgroups with US evaluation 1 day post-procedure, if evidence of inadvertent artery puncture/cannulation (communication between artery and collection or artery-vein, regardless of the thrombosis state). Major clinical events were encountered in 1.7% (15/870), 1.1% (3/265), and 0% of patients in US -/-, US -/+, and US +/+ group, respectively (P = 0.02 between US -/- and US +/+ group). In the US -/- group, 5/10 (50%) of pseudo-aneurysms were diagnosed during readmission after a mean of 24 ± 11 days post-procedure. No delayed presentation was seen in the US -/+ group. Major US events during the US protocol post-procedure were seen in 3.8% (10/265) vs. 0.3% (1/300) of patients in US -/+ vs. US +/+ group, respectively, P = 0.004. CONCLUSION: US-guided venipuncture was associated with a near-to-zero risk of vascular complications in our patients undergoing CB ablation.
Ströker et al. (Wed,) conducted a cohort in Atrial fibrillation (n=1,435). Vascular ultrasound for venipuncture guidance and post-procedural evaluation vs. No vascular ultrasound guidance or evaluation was evaluated on Major clinical complications (requiring intervention and/or prolonged stay) (p=0.02). Ultrasound-guided venipuncture was associated with a near-to-zero risk of major clinical vascular complications compared to no ultrasound guidance (0% vs 1.7%, P=0.02) during cryoballoon ablation.