Efficacy and Safety of Figure-of-Eight Suture for Hemostasis After Radiofrequency Catheter Ablation for Atrial Fibrillation

Abstract

Background: This study evaluated the safety and efficacy of venous figure-of-eight (FoE) suture to achieve femoral venous hemostasis after radiofrequency (RF) catheter ablation (CA) for atrial fibrillation (AF). Methods and Results:We retrospectively examined 517 consecutive patients undergoing RFCA for AF. The control group (n=247) underwent manual compression for femoral venous hemostasis after sheath removal with 6 h of bed rest. The FoE group (n=270) underwent FoE suture technique with 4 h of bed rest. All patients achieved successful hemostasis within 24 h after CA. Although the incidence of hematoma was similar between the groups, the incidence of rebleeding was lower in the FoE group than in the control group (FoE vs. control, 3.7% vs. 18.6%, P<0.001). The post-procedural use of analgesic and/or anti-emetic agents was less frequent in the FoE group (19.3% vs. 32.0%, P<0.001). On multiple logistic regression analysis after adjustment for age and sex, the use of a vitamin K antagonist (OR, 2.42; 95% CI: 1.18-4.99, P=0.02) and the FoE suture technique (OR, 0.17; 95% CI: 0.08-0.35, P<0.001) were independent predictors of rebleeding after CA.Conclusions: FoE suture technique effectively achieved femoral venous hemostasis after RFCA for AF. It reduced the risk of rebleeding, shortened bed rest duration, and relieved patient discomfort.

A comparison of figure‐of‐8‐suture versus manual compression for venous access closure after cardiac procedures: An updated meta‐analysis

“…Nine studies were found to be eligible based on the inclusion criteria. [4][5][6][8][9][10][11][12][13]…”

“…A total of 121 citations were identified after an intensive search process, 23 articles were assessed for eligibility, and 14 were excluded after screening. Nine studies were found to be eligible based on the inclusion criteria 4‐6,8–13 …”

The efficacy of the figure-of-eight suture technique in the treatment of tunnel bleeding of the femoral artery route after percutaneous coronary intervention or angiography

“…6,14,15 The FOE suture can reduce the risk of rebleeding, shorten the duration of bed rest and relieve patient discomfort. 6,15 When used for haemostasis following intervention via the femoral vein, the suture silks are placed in the site before removal of the catheter or catheter sheaths. 6 Considering the high risk of bleeding from the femoral artery, the FOE suture was inserted after removing the catheter or catheter sheaths and closing the femoral artery access site in this current study.…”

A randomized comparison of manual pressure versus figure‐of‐eight suture for hemostasis after cryoballoon ablation for atrial fibrillation

“…Retrospective and nonrandomized studies have demonstrated the safety of the figure‐of‐eight suture for hemostasis 8 . The largest published study, which was not randomized, included 512 patients undergoing radiofrequency catheter ablation of AF . These investigators demonstrated that use of the figure‐of‐eight suture was associated with a lower risk of rebleeding, shorter recovery times, and improved patient comfort.…”

“…8,9 The largest published study, which was not randomized, included 512 patients undergoing radiofrequency catheter ablation of AF. 8 These investigators demonstrated that use of the figure-of-eight suture was associated with a lower risk of rebleeding, shorter recovery times, and improved patient comfort. Similar findings have been observed in other nonrandomized trials for patients undergoing cryoballoon ablation for AF, which requires a larger venous sheath than utilized for radiofrequency ablation for AF.…”