Feasibility and clinical benefits of the double-ProGlide technique for hemostasis after cryoballoon atrial fibrillation ablation with uninterrupted oral anticoagulants

Jia-Yin SUN; Chang-Bo XUAN; Hai-Liang YU; Hai-Yang WANG; Hong-Ya HAN; Zhi-Ming ZHOU; De-An JIA; Dong-Mei SHI; Yu-Jie ZHOU; Shi-Wei YANG

doi:10.26599/1671-5411.2023.04.004

Volume 20 Issue 4

Apr. 2023

Turn off MathJax

Article Contents

Article Navigation > Journal of Geriatric Cardiology > 2023 > 20(4): 268-275

Please cite this article as: SUN JY, XUAN CB, YU HL, WANG HY, HAN HY, ZHOU ZM, JIA DA, SHI DM, ZHOU YJ, YANG SW. Feasibility and clinical benefits of the double-ProGlide technique for hemostasis after cryoballoon atrial fibrillation ablation with uninterrupted oral anticoagulants. J Geriatr Cardiol 2023; 20(4): 268−275. DOI: 10.26599/1671-5411.2023.04.004

Citation:

Please cite this article as: SUN JY, XUAN CB, YU HL, WANG HY, HAN HY, ZHOU ZM, JIA DA, SHI DM, ZHOU YJ, YANG SW. Feasibility and clinical benefits of the double-ProGlide technique for hemostasis after cryoballoon atrial fibrillation ablation with uninterrupted oral anticoagulants. J Geriatr Cardiol 2023; 20(4): 268−275. DOI: 10.26599/1671-5411.2023.04.004

Citation:

PDF( 2691 KB)

Feasibility and clinical benefits of the double-ProGlide technique for hemostasis after cryoballoon atrial fibrillation ablation with uninterrupted oral anticoagulants

doi: 10.26599/1671-5411.2023.04.004

1.
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, the Key Laboratory of Remodeling-Related Cardiovascular Disease, Ministry of Education, Beijing, China
2.
Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
3.
Department of Cardiology, Tangshan Fengrun District Second People’s Hospital, Hebei, China
4.
Department of Cardiology, Qingdao Municipal Hospital, Qingdao, China

More Information

Corresponding author: yang.shiwei@ccmu.edu.cn
Publish Date: 2023-04-28

Abstract

Abstract

OBJECTIVE To access the efficacy and safety of the double-ProGlide technique for the femoral vein access-site closure in cryoballoon ablation with uninterrupted oral anticoagulants (OAC), and its impact on the electrophysiology laboratory time as well as hospital stay after the procedure in this observational study. METHODS Patients with atrial fibrillation undergoing cryoballoon ablation with uninterrupted OAC at Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China from May 2019 to May 2021 were enrolled in this study. From October 2020, double-ProGlide technique was consistently used for hemostasis (ProGlide group), and before that conventional manual compression was utilized (manual compression group). The occurrence of vascular and groin complications was accessed during the hospital stay and until the three-month follow-up. RESULTS A total of 140 participants (69.30% of male, mean age: 59.21 ± 10.29 years) were evaluated, 70 participants being in each group. Immediate hemostasis was achieved in all the patients with ProGlide closure. No major vascular complications were found in the ProGlide group while two major vascular complications were occurred in the manual compression group. The incidence of any groin complication was obviously higher in subjects with manual compression than patients with ProGlide devices (15.71% vs. 2.86%, P = 0.009). In addition, compared with the manual compression group, the ProGlide group was associated with significantly shorter total time in the electrophysiology laboratory [112.0 (93.3–128.8) min vs. 123.5 (107.3–158.3) min, P = 0.006], time from sheath removal until venous site hemostasis [3.8 (3.4–4.2) min vs. 8.0 (7.6–8.5) min, P < 0.001], bed rest time [8.0 (7.6–8.0) h vs. 14.1 (12.0–17.6) h, P < 0.001] and hospital stay after the procedure [13.8 (12.5–17.8) h vs. 38.0 (21.5–41.0) h, P < 0.001]. CONCLUSIONS Utilization of the double-ProGlide technique for hemostasis after cryoballoon ablation with uninterrupted OAC is feasible and safe, which has the clinical benefit in reducing the total electrophysiology laboratory time and the hospital stay length after the procedure.

FullText(HTML)

References(30)

References

[1]	Andrade JG, Champagne J, Dubuc M, et al. Cryoballoon or radiofrequency ablation for atrial fibrillation assessed by continuous monitoring: a randomized clinical trial. Circulation 2019; 140: 1779−1788. doi: 10.1161/CIRCULATIONAHA.119.042622
[2]	Akkaya E, Berkowitsch A, Zaltsberg S, et al. Safety and feasibility of percutaneous skin closure using purse-string suture compared with compression bandage after pulmonary vein isolation. J Cardiovasc Electrophysiol 2017; 28: 1048−1057. doi: 10.1111/jce.13271
[3]	Deshmukh A, Patel NJ, Pant S, et al. In-hospital complications associated with catheter ablation of atrial fibrillation in the United States between 2000 and 2010: analysis of 93, 801 procedures. Circulation 2013; 128: 2104−2112. doi: 10.1161/CIRCULATIONAHA.113.003862
[4]	Burstein B, Barbosa RS, Kalfon E, et al. Venous thrombosis after electrophysiology procedures: a systematic review. Chest 2017; 152: 574−586. doi: 10.1016/j.chest.2017.05.040
[5]	Das R, Ahmed K, Athanasiou T, et al. Arterial closure devices versus manual compression for femoral haemostasis in interventional radiological procedures: a systematic review and meta-analysis. Cardiovasc Intervent Radiol 2011; 34: 723−738. doi: 10.1007/s00270-010-9981-0
[6]	Prada-Delgado Ó, Estévez-Loureiro R, Calviño-Santos R, et al. Safety and efficacy of femoral vascular closure devices in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction. Am Heart J 2011; 161: 1207−1213. doi: 10.1016/j.ahj.2011.03.009
[7]	Griese DP, Reents W, Diegeler A, et al. Simple, effective and safe vascular access site closure with the double-ProGlide preclose technique in 162 patients receiving transfemoral transcatheter aortic valve implantation. Catheter Cardiovasc Interv 2013; 82: E734−E741. doi: 10.1002/ccd.25053
[8]	Geis NA, Pleger ST, Chorianopoulos E, et al. Feasibility and clinical benefit of a suture-mediated closure device for femoral vein access after percutaneous edge-to-edge mitral valve repair. EuroIntervention 2015; 10: 1346−1353. doi: 10.4244/EIJV10I11A231
[9]	Hamid T, Rajagopal R, Pius C, et al. Preclosure of large-sized venous access sites in adults undergoing transcatheter structural interventions. Catheter Cardiovasc Interv 2013; 81: 586−590. doi: 10.1002/ccd.24358
[10]	Chinese Society of Pacing and Electrophysiology, Chinese Society of Arrhythmia. [Cryoballoon ablation of atrial fibrillation: consensus of Chinese experts]. Chin J Cardiac Arrhyth 2020; 34: 95−108. [In Chinese]. doi: 10.13333/j.cnki.cjcpe.2020.02.001
[11]	Wiley JM, White CJ, Uretsky BF. Noncoronary complications of coronary intervention. Catheter Cardiovasc Interv 2002; 57: 257−265. doi: 10.1002/ccd.10307
[12]	Kumar V, Wish M, Venkataraman G, et al. A randomized comparison of manual pressure versus figure-of-eight suture for hemostasis after cryoballoon ablation for atrial fibrillation. J Cardiovasc Electrophysiol 2019; 30: 2806−2810. doi: 10.1111/jce.14252
[13]	Noori VJ, Eldrup-Jørgensen J. A systematic review of vascular closure devices for femoral artery puncture sites. J Vasc Surg 2018; 68: 887−899. doi: 10.1016/j.jvs.2018.05.019
[14]	Zakko J, Scali S, Beck AW, et al. Percutaneous thoracic endovascular aortic repair is not contraindicated in obese patients. J Vasc Surg 2014; 60: 921−928. doi: 10.1016/j.jvs.2014.04.051
[15]	Power D, Schäfer U, Guedeney P, et al. Impact of percutaneous closure device type on vascular and bleeding complications after TAVR: a post hoc analysis from the BRAVO-3 randomized trial. Catheter Cardiovasc Interv 2019; 93: 1374−1381. doi: 10.1002/ccd.28295
[16]	Del Prete A, Della Rocca DG, Calcagno S, et al. Perclose Proglide™ for vascular closure. Future Cardiol 2021; 17: 269−282. doi: 10.2217/fca-2020-0065
[17]	Ozawa A, Chaturvedi R, Lee KJ, et al. Femoral vein hemostasis in children using a suture-mediated closure device. J Interv Cardiol 2007; 20: 164−167. doi: 10.1111/j.1540-8183.2007.00241.x
[18]	Mylonas I, Sakata Y, Salinger M, et al. The use of percutaneous suture-mediated closure for the management of 14 French femoral venous access. J Invasive Cardiol 2006; 18: 299−302.
[19]	Shaw JA, Dewire E, Nugent A, et al. Use of suture-mediated vascular closure devices for the management of femoral vein access after transcatheter procedures. Catheter Cardiovasc Interv 2004; 63: 439−443. doi: 10.1002/ccd.20190
[20]	Kar S, Hermiller J, Conn K, et al. CRT-200.28 The use of the Perclose Proglide suture mediated closure (SMC) device for vein artery access site closure up to 24 F sheaths. JACC Cardiovasc Interv 2018; 11: S35. doi: 10.1016/j.jcin.2018.01.112
[21]	Hamid T, Rajagopal R, Pius C, et al. Preclosure of large-sized venous access sites in adults undergoing transcatheter structural interventions. Catheter Cardiovasc Interv 2013; 81: 586−590. doi: 10.1002/ccd.24358
[22]	Akkaya E, Sözener K, Rixe J, et al. Venous access closure using a purse-string suture without heparin antagonism or additional compression after MitraClip implantation. Catheter Cardiovasc Interv 2020; 96: 179−186. doi: 10.1002/ccd.28534
[23]	Velagic V, Mugnai G, Pasara V, et al. Use of figure of eight suture for groin closure with no heparin reversal in patients undergoing cryoballoon ablation for atrial fibrillation. J Interv Card Electrophysiol 2021; 60: 433−438. doi: 10.1007/s10840-020-00776-0
[24]	Calkins H, Hindricks G, Cappato R, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace 2018; 20: e1−e160. doi: 10.1093/europace/eux274
[25]	Nakamura R, Okishige K, Shigeta T, et al. Clinical comparative study regarding interrupted and uninterrupted dabigatran therapy during perioperative periods of cryoballoon ablation for paroxysmal atrial fibrillation. J Cardiol 2019; 74: 150−155. doi: 10.1016/j.jjcc.2019.02.003
[26]	Bagoly Z, Hajas O, Urbancsek R, et al. Uninterrupted dabigatran administration provides greater inhibition against intracardiac activation of hemostasis as compared to vitamin K antagonists during cryoballoon catheter ablation of atrial fibrillation. J Clin Med 2020; 9: 3050. doi: 10.3390/jcm9093050
[27]	Nakamura R, Okishige K, Shigeta T, et al. Clinical comparative study regarding interrupted and uninterrupted dabigatran therapy during perioperative periods of cryoballoon ablation for paroxysmal atrial fibrillation. J Cardiol 2019; 74: 150−155. doi: 10.1016/j.jjcc.2019.02.003
[28]	Ando M, Inden Y, Yoshida Y, et al. Differences in prothrombotic response between the uninterrupted and interrupted apixaban therapies in patients undergoing cryoballoon ablation for paroxysmal atrial fibrillation: a randomized controlled study. Heart Vessels 2019; 34: 1533−1541. doi: 10.1007/s00380-019-01370-9
[29]	Matsunaga-Lee Y, Egami Y, Yanagawa K, et al. Limited efficacy of a figure-of-eight suture for hemostasis after cryoballoon atrial fibrillation ablation with uninterrupted oral anticoagulants. J Cardiol 2020; 76: 30−34. doi: 10.1016/j.jjcc.2020.01.012
[30]	Lakshmanadoss U, Wong WS, Kutinsky I, et al. Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation. Indian Pacing Electrophysiol J 2017; 17: 134−139. doi: 10.1016/j.ipej.2017.02.003