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Prevention of venous thrombosis after electrophysiology procedures: a survey of national practice

  • Barry Burstein
  • Rodrigo S. Barbosa
  • Michelle Samuel
  • Eli Kalfon
  • François Philippon
  • David Birnie
  • Iqwal Mangat
  • Damian Redfearn
  • Roopinder Sandhu
  • Laurent Macle
  • John Sapp
  • Atul Verma
  • Jeff S. Healey
  • Giuliano Becker
  • Vijay Chauhan
  • Benoit Coutu
  • Jean-François Roux
  • Peter Leong-Sit
  • Jason G. Andrade
  • George D. Veenhuyzen
  • Jacqueline Joza
  • Martin Bernier
  • Vidal Essebag
Article
  • 33 Downloads

Abstract

Purpose

Femoral venous access is required for most electrophysiology procedures. Limited data are available regarding post-procedure venous thromboembolism (VTE), specifically deep vein thrombosis (DVT) and pulmonary embolism (PE). Potential preventative strategies are unclear. We aimed to survey Canadian centers regarding incidence of VTE and strategies for prevention of VTE after procedures that do not require post-procedure anticoagulation.

Methods

An online survey was distributed to electrophysiologists representing major Canadian EP centers. Participants responded regarding procedural volume, incidence of VTE post-procedure, and their practice regarding pharmacological and non-pharmacological peri-procedural VTE prophylaxis.

Results

The survey included 17 centers that performed a total of 6062 procedures in 2016. Ten patients (0.16%) had VTE (including 9 DVTs and 6 PEs) after diagnostic electrophysiology studies and right-sided ablation procedures excluding atrial flutter. Five centers (41.6%) administered systemic intravenous heparin during both diagnostic electrophysiology studies and right-sided ablation procedures. For patients taking oral anticoagulants, 10 centers (58.8%) suspend therapy prior to the procedure. Two centers (11.8%) routinely prescribed post-procedure pharmacologic prophylaxis for VTE. Four centers (23.5%) used compression dressings post-procedure and all prescribed bed rest for a maximum of 6 h. Of the variables collected in the survey, none were found to be predictive of VTE.

Conclusions

VTE is not a common complication of EP procedures. There is significant variability in the strategies used to prevent VTE events. Future research is required to evaluate strategies to reduce the risk of VTE that may be incorporated into EP practice guidelines.

Keywords

Electrophysiology study Ablation Deep vein thrombosis Prevention Prophylaxis 

Notes

Acknowledgements

Drs. Essebag, Sapp, Joza, Andrade, Birnie, Healey, Leong-Sit, Philippon, Redfearn, and Sandhu are Network Investigators of the Cardiac Arrhythmia Network of Canada (CANet).

Funding

This work was supported by a Clinical Research Scholar Award to Vidal Essebag from Fonds de recherche du Quebec-Santé (FRQS).

Compliance with ethical standards

The study was approved by the McGill University Health Centre (MUHC) Research Ethics Board (REB).

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10840_2018_461_MOESM1_ESM.docx (18 kb)
ESM 1 (DOCX 17 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Barry Burstein
    • 1
  • Rodrigo S. Barbosa
    • 1
    • 2
  • Michelle Samuel
    • 1
  • Eli Kalfon
    • 1
    • 3
  • François Philippon
    • 4
  • David Birnie
    • 5
  • Iqwal Mangat
    • 6
  • Damian Redfearn
    • 7
  • Roopinder Sandhu
    • 8
  • Laurent Macle
    • 9
  • John Sapp
    • 10
  • Atul Verma
    • 11
  • Jeff S. Healey
    • 12
  • Giuliano Becker
    • 13
  • Vijay Chauhan
    • 14
  • Benoit Coutu
    • 15
  • Jean-François Roux
    • 16
  • Peter Leong-Sit
    • 17
  • Jason G. Andrade
    • 18
  • George D. Veenhuyzen
    • 19
  • Jacqueline Joza
    • 1
  • Martin Bernier
    • 1
  • Vidal Essebag
    • 1
    • 13
    • 20
  1. 1.McGill University Health CentreMontrealCanada
  2. 2.Hospital Albert SabinJuiz de ForaBrazil
  3. 3.Galilee Medical CenterNahariyaIsrael
  4. 4.Institut universitaire de cardiologie et de pneumologie de QuébecQuébecCanada
  5. 5.University of Ottawa Heart InstituteOttawaCanada
  6. 6.St. Michael’s HospitalTorontoCanada
  7. 7.Kingston Health Sciences CentreKingstonCanada
  8. 8.University of Alberta HospitalEdmontonCanada
  9. 9.Montreal Heart InstituteMontréalCanada
  10. 10.QEII Health Sciences CentreHalifaxCanada
  11. 11.Southlake Regional Health CentreNewmarketCanada
  12. 12.Hamilton Health Sciences CentreHamiltonCanada
  13. 13.Hôpital Sacré-Coeur de MontréalMontréalCanada
  14. 14.University Health Network, University of TorontoTorontoCanada
  15. 15.Centre hospitalier de l’Université de Montréal (CHUM)MontrealCanada
  16. 16.Centre hospitalier universitaire de Sherbrooke (CHUS)SherbrookeCanada
  17. 17.London Health Sciences CentreLondonCanada
  18. 18.Vancouver General HospitalVancouverCanada
  19. 19.Libin Cardiovascular Institute of AlbertaUniversity of CalgaryCalgaryCanada
  20. 20.McGill University Health CentreMontrealCanada

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