{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:44:24Z","timestamp":1782978264892,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Methods for femoral venous haemostasis following electrophysiology (EP) procedures include manual compression (MC) and suture\u2010based techniques such as a figure\u2010of\u2010eight suture secured with a hand\u2010tied knot (Fo8<jats:sub>HT<\/jats:sub>) or a modified figure\u2010of\u2010eight suture secured with a 3\u2010way stopcock (Fo8<jats:sub>MOD<\/jats:sub>). We hypothesised that short\u2010term bleeding outcomes using the Fo8<jats:sub>MOD<\/jats:sub> approach would be superior to MC. We additionally compared outcomes between Fo8<jats:sub>MOD<\/jats:sub> and Fo8<jats:sub>HT<\/jats:sub> approaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied consecutive patients undergoing EP procedures at our institution between March and December 2023. Patients were categorised into three haemostasis groups: MC, Fo8<jats:sub>HT<\/jats:sub> and Fo8<jats:sub>MOD<\/jats:sub>. Access site complications were classified as major (requiring intervention or blood transfusion, delaying discharge or resulting in death) or minor (bleeding\/haematoma requiring additional compression).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>1089 patients were included: MC 718 (65.9%); Fo8<jats:sub>HT<\/jats:sub> 105 (9.6%); Fo8<jats:sub>MOD<\/jats:sub> 266 (24.4%). Procedures were most commonly for atrial fibrillation (52.4%), atrial flutter (10.9%), and atrioventricular nodal re\u2010entrant tachycardia (10.1%). In patients receiving periprocedural anticoagulation (865, 79.4%), Fo8<jats:sub>MOD<\/jats:sub> associated with fewer complications than MC or Fo8<jats:sub>HT<\/jats:sub> (major: MC 2.2%, Fo8<jats:sub>HT<\/jats:sub> 6.0%, Fo8<jats:sub>MOD<\/jats:sub> 0.8%, <jats:italic>p<\/jats:italic>\u2009=\u2009.01; minor: MC 16.5%, Fo8<jats:sub>HT<\/jats:sub> 12.0%, Fo8<jats:sub>MOD<\/jats:sub> 7.4%, <jats:italic>p<\/jats:italic>\u2009=\u2009.002). In patients not receiving periprocedural anticoagulation, complications did not differ between haemostasis methods (total major and minor complications 5.8%, <jats:italic>p<\/jats:italic>\u2009=\u2009.729 for between groups rates). On multivariable logistic regression, Fo8<jats:sub>MOD<\/jats:sub> was associated with a significantly lower risk of access site complications (OR 0.29 [95% CI 0.17\u20130.48], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), whilst intraprocedural heparinisation (OR 5.25 [2.88\u20139.69], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and larger maximal sheath size (OR 1.06 [1.00\u20131.11], <jats:italic>p<\/jats:italic>\u2009=\u2009.04) were associated with a higher risk of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Femoral haemostasis with Fo8<jats:sub>MOD<\/jats:sub> associates with fewer access site complications than MC and Fo8<jats:sub>HT<\/jats:sub> following EP procedures that need periprocedural anticoagulation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16417","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T05:12:21Z","timestamp":1725513141000},"page":"2119-2127","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Suture\u2010based techniques versus manual compression for femoral venous haemostasis after electrophysiology procedures"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5425-7739","authenticated-orcid":false,"given":"Mark T.","family":"Mills","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool UK"},{"name":"Liverpool Heart &amp; Chest Hospital NHS Foundation Trust Thomas Drive Liverpool L14 3PE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8401-4033","authenticated-orcid":false,"given":"Peter","family":"Calvert","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool UK"},{"name":"Liverpool Heart &amp; Chest Hospital NHS Foundation Trust Thomas Drive Liverpool L14 3PE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Snowdon","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saagar","family":"Mahida","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Waktare","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5648-7418","authenticated-orcid":false,"given":"Zoltan","family":"Borbas","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Ashrafi","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derick","family":"Todd","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3520-6124","authenticated-orcid":false,"given":"Simon","family":"Modi","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3274-7128","authenticated-orcid":false,"given":"Vishal","family":"Luther","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool UK"},{"name":"Liverpool Heart &amp; Chest Hospital NHS Foundation Trust Thomas Drive Liverpool L14 3PE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3490-090X","authenticated-orcid":false,"given":"Dhiraj","family":"Gupta","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital Liverpool UK"},{"name":"Liverpool Heart &amp; Chest Hospital NHS Foundation Trust Thomas Drive Liverpool L14 3PE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-020-02333-y"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.03.418"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euad361"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.05.017"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-021-00948-6"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.33963\/KP.a2022.0148"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13712"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13764"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.14008"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-015-0036-y"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv375"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ipej.2017.02.003"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13271"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-17-1213"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13405"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14252"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27003"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.7150\/ijms.42593"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.16417","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T06:38:31Z","timestamp":1730875111000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.16417"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,4]]},"references-count":18,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/jce.16417"],"URL":"https:\/\/doi.org\/10.1111\/jce.16417","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,4]]},"assertion":[{"value":"2024-07-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}