Real-World Experience with a New Vascular Closure Device in Patients Undergoing Electrophysiology Procedures with Large Bore Sheaths

Background Vascular closure devices offer proven benefits over manual compression for femoral venous access site management after electrophysiology procedures. The VASCADE MVP XL closure system performance in procedures using large-bore sheaths (up to 14 Fr inner diameter [ID], 17Fr outer diameter [OD]) remains insufficiently evaluated in real-world setting. Objective To evaluate real-world outcomes in patients who received the VASCADE MVP XL device following large bore venous access electrophysiology procedures. Methods This retrospective cohort study analyzed patients who received VASCADE MVP XL devices from 1/1/2024 to 10/30/2025 following atrial fibrillation (AF) pulsed field ablation (PFA), left atrial appendage closure (LAAC), or concomitant procedures. Primary outcomes included time to hemostasis (TTH), time to discharge (TTD), and same-day discharge (SDD) rates, stratified by gender and procedure type. Multivariable linear and logistic regression models assessed outcomes. Secondary outcomes were 30-day complication rates. Results A total of 1,623 patients (35.4% females, median age 71 years) underwent procedures with VASCADE MVP XL closure. Procedures included 73.9% AF PFA, 18.4% LAAC, and 7.6% concomitant procedures. Median TTH was 2 minutes (IQR 1-4), and median TTD was 3.5 hours (IQR 2.9-4.5). The SDD rate was 92.5%. After multivariable adjustment, no significant differences in TTH, TTD, or SDD were observed between gender and procedure types (all P>0.05). Thirty-day complications occurred in 20 (1.2%) patients. Conclusions These findings provide valuable real-world evidence supporting the safety and efficacy of the VASCADE MVP XL closure system in large-bore sheath procedures such as AF PFA, LAAC, or concomitant procedures.