Ultrasound-Guided Vascular Access Procedure Associated with Fewer Complications in Patients with Atrial Fibrillation

JULY 28, 2016
Andrew Smith
Retrospective analysis of ablation outcomes before and after a medical center began using ultrasound to guide vascular access indicates that the technology significantly reduces complications.
Investigators gathered outcome data on 689 consecutive patients who underwent 720 ablation procedures at Virginia Commonwealth University Medical Center. A total of 357 procedures took place before June, 2015, when surgeons there began using ultrasound-guided vascular access on all patients. The remaining 363 took place afterward after the transition. Nearly half of all the patients (48%) underwent ablation to treat atrial fibrillation (AF).
Overall, 19 of the procedures that were not guided by ultrasound (5.3%) resulted in some sort of complication compared to 4 of the ultrasound-guided ablations (1.1%). Analysis showed this to be a significant difference (p = 0.002).  Major complications were also more common in surgeries that were not guided by ultrasound (9 [2.5%] vs 2 [0.6%]; p = 0.03].
“In a large series of patients undergoing catheter based EP procedures for cardiac arrhythmias, ultrasound guided vascular access was associated with a significantly decreased 30-day risk of vascular complications,” the study authors wrote in the Journal of Cardiovascular Electrophysiology.
The conclusions of the new study echo those of another evaluation of ultrasound guidance that appeared in the Journal of the American College of Cardiology a few months ago.

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