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Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation

INTRODUCTION: Limited data exists for types of venous closure and its associated complications in patients after atrial fibrillation (AF) catheter ablation. We evaluated the subcutaneous figure-of-eight closure (FO8) for achieving venous hemostasis after AF catheter ablation compared to manual press...

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Autores principales: Lakshmanadoss, Umashankar, Wong, Wai Shun, Kutinsky, Ilana, Khalid, M. Rizwan, Williamson, Brian, Haines, David E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652276/
https://www.ncbi.nlm.nih.gov/pubmed/29192589
http://dx.doi.org/10.1016/j.ipej.2017.02.003
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author Lakshmanadoss, Umashankar
Wong, Wai Shun
Kutinsky, Ilana
Khalid, M. Rizwan
Williamson, Brian
Haines, David E.
author_facet Lakshmanadoss, Umashankar
Wong, Wai Shun
Kutinsky, Ilana
Khalid, M. Rizwan
Williamson, Brian
Haines, David E.
author_sort Lakshmanadoss, Umashankar
collection PubMed
description INTRODUCTION: Limited data exists for types of venous closure and its associated complications in patients after atrial fibrillation (AF) catheter ablation. We evaluated the subcutaneous figure-of-eight closure (FO8) for achieving venous hemostasis after AF catheter ablation compared to manual pressure. METHODS: 284 consecutive patients that underwent AF catheter ablation by two operators were included. All patients received continuous therapeutic warfarin or interrupted novel oral anticoagulants (NOAC) and heparin (ACT300-400 s) without reversal. Patients were divided into two groups: 1) sheaths were left in place and pulled once ACT < 180 s, with hemostasis being achieved with manual pressure (MP); and 2) a subcutaneous FO8 suture closed the venous access site immediately after the ablation on each groin site and sheaths were removed immediately after the ablation despite full anticoagulation with heparin and warfarin or interrupted NOAC. Sutures were removed after four hours, and the patients laid flat for an additional two hours. RESULTS: The MP group (n = 105) was similar to the FO8 group (n = 179). Time in bed was 573 ± 80 min for MP group vs. 373 ± 49 min for FO8 group (p < 0.0001). Eleven hematomas were seen in the MP group compared to seven in the FO8 group (P = 0.041). CONCLUSIONS: In fully anticoagulated patients undergoing AF catheter ablation, excellent hemostasis was achieved with figure-of-eight sutures, with no major vascular complications, a lower hematoma rate, and a significantly shorter flat-time-in-bed compared to manual pressure.
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spelling pubmed-56522762017-10-30 Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation Lakshmanadoss, Umashankar Wong, Wai Shun Kutinsky, Ilana Khalid, M. Rizwan Williamson, Brian Haines, David E. Indian Pacing Electrophysiol J Original Article INTRODUCTION: Limited data exists for types of venous closure and its associated complications in patients after atrial fibrillation (AF) catheter ablation. We evaluated the subcutaneous figure-of-eight closure (FO8) for achieving venous hemostasis after AF catheter ablation compared to manual pressure. METHODS: 284 consecutive patients that underwent AF catheter ablation by two operators were included. All patients received continuous therapeutic warfarin or interrupted novel oral anticoagulants (NOAC) and heparin (ACT300-400 s) without reversal. Patients were divided into two groups: 1) sheaths were left in place and pulled once ACT < 180 s, with hemostasis being achieved with manual pressure (MP); and 2) a subcutaneous FO8 suture closed the venous access site immediately after the ablation on each groin site and sheaths were removed immediately after the ablation despite full anticoagulation with heparin and warfarin or interrupted NOAC. Sutures were removed after four hours, and the patients laid flat for an additional two hours. RESULTS: The MP group (n = 105) was similar to the FO8 group (n = 179). Time in bed was 573 ± 80 min for MP group vs. 373 ± 49 min for FO8 group (p < 0.0001). Eleven hematomas were seen in the MP group compared to seven in the FO8 group (P = 0.041). CONCLUSIONS: In fully anticoagulated patients undergoing AF catheter ablation, excellent hemostasis was achieved with figure-of-eight sutures, with no major vascular complications, a lower hematoma rate, and a significantly shorter flat-time-in-bed compared to manual pressure. Elsevier 2017-02-20 /pmc/articles/PMC5652276/ /pubmed/29192589 http://dx.doi.org/10.1016/j.ipej.2017.02.003 Text en Copyright © 2017, Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Lakshmanadoss, Umashankar
Wong, Wai Shun
Kutinsky, Ilana
Khalid, M. Rizwan
Williamson, Brian
Haines, David E.
Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation
title Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation
title_full Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation
title_fullStr Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation
title_full_unstemmed Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation
title_short Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation
title_sort figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652276/
https://www.ncbi.nlm.nih.gov/pubmed/29192589
http://dx.doi.org/10.1016/j.ipej.2017.02.003
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