Ultrasound guided vascular access in the electrophysiology lab: should it be a standard of care?

Excerpt

Catheter directed electrophysiology (EP) studies and ablations have emerged as common and widely accepted therapies for various types of arrhythmia. The femoral vasculatures serve as access sites, in the majority of instances. Despite the need for multiple venous sheath placement within a single vein, early reporting of vascular related bleeding complications was naught [1, 2]. With increasing frequency of complex procedures such as pulmonary vein antral isolation (PVAI) performed with maintenance of peri-procedural anticoagulation and those necessitating arterial access, vascular complication rates rose to 1–2% [3, 4]. In spite of advancements in catheter-based EP procedures in the past two decades leading to improved efficacy and overall safety, the incidence of vascular complication has remained unchanged [5, 6]. …