Vascular closure devices in electrophysiology procedures: Systematic review and meta-analysis.

BACKGROUND

Vascular closure devices (VCDs) have been shown to reduce the time to hemostasis in single-point arterial access sites, but their benefit in electrophysiology (EP) procedures requiring multipoint venous access remains uncertain.

OBJECTIVE

This study aimed to perform a systematic review and meta-analysis evaluating the efficacy and safety of VCDs compared with manual compression or figure-of-8 suture for venous hemostasis after EP procedures.

METHODS

A systematic search of PubMed, Scopus, and Google Scholar was conducted in June 2025 to identify randomized controlled trials comparing VCDs with manual or figure-of-8 closure in EP procedures.

RESULTS

6 randomized controlled trials including 848 patients (460 treated with VCDs) were analyzed. VCDs significantly reduced hematoma formation (3.4% vs 7.7%; odds ratio, 0.51; 95% confidence interval, 0.25-0.92; P = .03) and a composite outcome of all vascular complications (10.4% vs 17.2%; odds ratio, 0.70; 95% confidence interval, 0.50-0.98; P = .04). Times to hemostasis, ambulation, and disposition were significantly shorter in the VCD group by 5.5, 129, and 84 minutes, respectively.

CONCLUSION

VCDs modestly reduce vascular complications and significantly shorten recovery time after EP procedures.