Immediate Leg Mobilization is Feasible After Catheter Ablation of Atrial Fibrillation Using Large Vascular Access Sheaths (Pulsed Field and Cryoballoon Ablation).

BACKGROUND

Vascular recovery from catheter ablation (CA) has traditionally required a period of leg immobilization which can lead to discomfort and prolonged time to discharge.

OBJECTIVE

The objective of this study was to compare a strategy of immediate leg mobilization (IM) using suture-mediated closure devices against traditional vascular recovery consisting of figure-of-eight suture and 4 h bed rest (BR) after CA of atrial fibrillation (AF) using large vascular access sheaths for cryoballoon ablation (CBA) and pulsed field ablation (PFA).

METHODS

Two hundred subjects were retrospectively analyzed: 100 IM and 100 BR. Vascular closure in IM consisted of a single suture-mediated closure delivered to each of three venotomies. Following the procedure, both legs could be mobilized immediately with no head-of-bed restriction. Ambulation was instructed at 1 h, and discharge at 3 h postprocedure. Hemostasis in BR was achieved using figure-of-eight sutures and 4 h of BR. The primary endpoint was the incidence of vascular complications. The secondary endpoint was time to discharge.

RESULTS

The mean age was 68.4 ± 11.7 years. In total, 72% of subjects in IM and 5% of the subjects in BR were treated with PFA. There was no difference in vascular complications (1 IM vs. 0 BR, p = 0.316). Time to discharge was shorter in IM (4.2 ± 2.6 h vs. 6.0 ± 2.7 h, p < 0.05).

CONCLUSION

Immediate mobilization with suture-mediated vascular closure following CBA or PFA was associated with no difference in vascular complications compared to 4 h BR and shorter time to discharge. Further studies are needed to illustrate potential benefits to patient comfort and satisfaction.