P5755Real-time ultrasound guidance for venous access reduces vascular complications in women aged 75 years or older undergoing catheter ablation for atrial fibrillation under uninterrupted anticoagulation

Background: After the age of 75 years, about 60% of the people with atrial fibrillation (AF) are women. Female gender is also a known independent predictor of vascular complications in AF patients undergoing catheter ablation. Real-time ultrasound allows direct visualization of vascular structures. Thus, it is logical that it can reduce the inadvertent trauma to the femoral vein and artery thereby decreasing the vascular complications, especially in patients under anticoagulant therapy. Objective: We evaluated the rate of vascular complications in traditional landmark-based and the ultrasound (US)-guided venipuncture in women ≥75 years undergoing AF ablation. Methods: A total of 496 women aged ≥75 years undergoing femoral vein-access for AF ablation were included in this retrospective analysis and classified to group 1: landmark-based access: n=217 and group 2: US-guided access: n=279. The primary endpoint was vascular access complications requiring intervention such as hematoma, pseudoaneurysm, arteriovenous fistula and access bleeding needing blood transfusion.