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Figure‐of‐eight sutures for hemostasis result in shorter lab recovery time after ablation for atrial fibrillation
Author(s) -
Payne Joshua,
Bickel Trent,
Gautam Sandeep
Publication year - 2018
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13405
Subject(s) - medicine , hemostasis , atrial fibrillation , ablation , surgery , anesthesia , heparin , retrospective cohort study , fibrous joint , cardiology
Background Ablation for atrial fibrillation (AF) requires multiple venous sheaths and anticoagulation with heparin, both risk factors for bleeding complications. Manual compression (MC) with heparin reversal is the standard method to achieve venous hemostasis postablation; however, temporary figure‐of‐eight sutures (F8S) are an alternative. While this technique has been shown to be safe and effective, little is known about its effect on postprocedural recovery time. Methods In this retrospective cohort study, consecutive patients who underwent AF radiofrequency ablation over a 23‐month period were reviewed for type of hemostasis (manual compression or figure‐of‐eight suture), demographics, periprocedural anticoagulation, groin complications, and procedural duration. Results A total of 104 patients were included (42 in the MC group and 62 in the F8S group). The two groups were similar for mean age, gender, weight, oral anticoagulant use, and procedural heparin dosing. Access site complications were 4.76% versus 3.23% (P = 0.68). Time from procedure end to sheath removal was lower in the F8S group (16.2 ± 8.47 vs 4.25 ± 4.14 min, P < 0.0001). Overall time from procedure end to hemostasis was 36.1 ± 10.1 min in the MC group versus 7.9 ± 5.6 in the F8S group (P < 0.0001). Times to extubation and transport out of the lab were both significantly lower in the F8S group (34.1 ± 14.6 vs 13.5 ± 5.4 min, and 44 ± 14.6 vs 21.9 ± 6.7 min, respectively, P < 0.0001). Conclusion Figure‐of‐eight sutures provided efficient hemostasis following AF ablation, with significantly reduced postprocedure recovery time including time to hemostasis, extubation, and transport out of the lab.