title: Feasibility and safety of temporary subcutaneous venous figure-of-eight suture to achieve haemostasis after ablation of atrial fibrillation.
abstract: OBJECTIVE
  This prospective study was carried out to assess the feasibility and safety of venous figure-of-eight suture to achieve haemostasis after atrial fibrillation (AF) ablation.
  
  
  RESULTS
  Consecutive patients who underwent catheter ablation of AF were prospectively enrolled from February 2012 to September 2013. At the end of the procedure, a temporary subcutaneous 'Figure-of-eight' suture technique was used to achieve haemostasis. Anticoagulation strategy evolved during the study. Initially, vitamin K antagonists (VKAs) were stopped and replaced by administration of low-molecular-weight heparin. It was subsequently decided to perform these procedures without stopping VKA. With the arrival of direct oral anticoagulants (DOACs), it was decided to miss the evening dose before the procedure. One hundred and twenty-four patients were included. Seventy-three per cent of patients were male, and the mean age was 58 ± 10 years old. One hundred and twelve patients (90%) experienced paroxysmal AF and were treated by cryotherapy with the use of a 15 Fr outer diameter Flexcath Advance sheath. The 'Figure-of-eight' suture technique was able to be performed in all patients and was sufficient in 114 patients. Mechanical external compression was required for 10 patients. Three patients developed a haematoma. The overall incidence of haematoma was therefore 2.4%.
  
  
  CONCLUSIONS
  Figure-of-eight suture is a fast closure technique that can be used as an efficient alternative to usual compression methods to prevent bleeding during high-intensity anticoagulation and the use of large-diameter venous sheaths and multiple femoral venous accesses.
authors.affiliation: Amiens University Hospital, Amiens, France traulle.sarah@chu-amiens.fr.
authors.forename: Sarah
authors.initials: S
authors.lastname: Traullé
authors.affiliation: Amiens University Hospital, Amiens, France.
authors.forename: Maciej
authors.initials: M
authors.lastname: Kubala
authors.affiliation: Amiens University Hospital, Amiens, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Doucy
authors.affiliation: Amiens University Hospital, Amiens, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Quenum
authors.affiliation: Amiens University Hospital, Amiens, France.
authors.forename: Jean-Sylvain
authors.initials: JS
authors.lastname: Hermida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D005240:Feasibility Studies; D005260:Female; D005602:France; D006406:Hematoma / Q000453:epidemiology; D006470:Hemorrhage / Q000517:prevention & control; D006487:Hemostasis; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D013536:Suture Techniques; D013923:Thromboembolism / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants
keywords: Ablation; Atrial fibrillation; Complications; Haematoma; Haemostasis; Suture technique