Key result
A temporary subcutaneous venous figure-of-eight suture was sufficient to achieve haemostasis in 114 of 124 patients after atrial fibrillation ablation, with a 2.4% incidence of haematoma.
Why the study?
Does a temporary subcutaneous venous figure-of-eight suture safely and effectively achieve haemostasis in patients undergoing catheter ablation for atrial fibrillation?
Observational (n=124)
Does a temporary subcutaneous venous figure-of-eight suture safely and effectively achieve haemostasis in patients undergoing catheter ablation for atrial fibrillation?
A temporary subcutaneous venous figure-of-eight suture is a feasible and safe alternative to mechanical compression for achieving haemostasis after AF ablation using large-diameter sheaths.
May offer alternative to mechanical compression after AF ablation; leaves open need for randomized confirmation before practice change.
AIMS: This prospective study was carried out to assess the feasibility and safety of venous figure-of-eight suture to achieve haemostasis after atrial fibrillation (AF) ablation. METHODS AND RESULTS: Consecutive patients who underwent catheter ablation of AF were prospectively enrolled from February 2012 to September 2013. At the end of the procedure, a temporary subcutaneous 'Figure-of-eight' suture technique was used to achieve haemostasis. Anticoagulation strategy evolved during the study. Initially, vitamin K antagonists (VKAs) were stopped and replaced by administration of low-molecular-weight heparin. It was subsequently decided to perform these procedures without stopping VKA. With the arrival of direct oral anticoagulants (DOACs), it was decided to miss the evening dose before the procedure. One hundred and twenty-four patients were included. Seventy-three per cent of patients were male, and the mean age was 58 ± 10 years old. One hundred and twelve patients (90%) experienced paroxysmal AF and were treated by cryotherapy with the use of a 15 Fr outer diameter Flexcath Advance sheath. The 'Figure-of-eight' suture technique was able to be performed in all patients and was sufficient in 114 patients. Mechanical external compression was required for 10 patients. Three patients developed a haematoma. The overall incidence of haematoma was therefore 2.4%. CONCLUSION: Figure-of-eight suture is a fast closure technique that can be used as an efficient alternative to usual compression methods to prevent bleeding during high-intensity anticoagulation and the use of large-diameter venous sheaths and multiple femoral venous accesses.
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Traullé et al. (2015) conducted an observational in Atrial fibrillation (n=124). Temporary subcutaneous venous figure-of-eight suture was evaluated on Incidence of haematoma. A temporary subcutaneous venous figure-of-eight suture was sufficient to achieve haemostasis in 114 of 124 patients after atrial fibrillation ablation, with a 2.4% incidence of haematoma.
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