Allied Professionals (Non-physician submissions only) -> Clinical Research D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-049 - Safety And Efficacy Of Closure Techniques After Pulmonary Vein Antrum Isolation (ID 59)

 F. Houtzager: Nothing relevant to disclose.


Background: After catheter ablation for atrial fibrillation (AF), manual compression (MC) is commonly used to achieve venous hemostasis, requiring prolonged immobilization. Alternatively, the access site can be closed using figure-of-8 suture (FO8) or a closure device. Two closure devices have been FDA approved for venous use, Vascade and Proglide (PCD). Vascade was shown to reduce immobilization and increase patient satisfaction but is not currently available in Europe, whereas PCD is available, but less well studied.
Objective: The aim of this study was to retrospectively compare manual compression with Fo8 and PCD.
Methods: Records of patients who underwent catheter ablation for AF between 2016 and 2019 were retrospectively studied. We included 100 consecutive patients who received MC, 100 patients who received FO8 and 100 patients who received the PCD. Duration of immobilization, occurrence of urinary retention, back pain and vascular complications were recorded. The study was approved by the institutional review board.
Results: Manual compression was associated with the longest duration of immobilization (13.6 ± 2.7h) compared with FO8 (10.2 ± 1.5h) and PCD (6.5 ± 3.1h) P<0.001, highest incidence of urinary retention (MC 33.3% vs FO8 23% and PCD 16.8% P=0.023) and highest pain score on a scale of 0 - 10 (MC 2.5 ± 2.2 vs FO8 1.3 ± 2.2 vs. PCD 0.0 ± 0.0) P<0.001. There were no differences in vascular complications between the groups: hematoma (MC 8.1% vs FO8 11% and PCD 8% P = 0.701).
Conclusion: The data suggest that the use of PCD reduces the immobilization period, urinary retention and pain perception. PCD usage was safe and non-inferior in terms of vascular complications.