PREVENTION OF VENOUS THROMBOSIS AFTER ELECTROPHYSIOLOGY PROCEDURES: A SURVEY OF CANADIAN PRACTICE

Background

Femoral venous access is required for most electrophysiology (EP) procedures. Venous thromboembolism (VTE) is an important potential complication of EP procedures, with potential acute and chronic sequelae. Limited data are available regarding post-procedure VTE, specifically deep vein thrombosis (DVT) and pulmonary embolism (PE). The most recent position statement from EP professional societies does not reference which strategies, if any, should be used to prevent VTE; specifically, pertaining

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. Predictors of VTE were determined by univariate and multivariate logistic regression.

Results

The survey included 17 centers that performed a total of 6062 procedures in 2016 (Table). Ten patients (0.16%) had VTE (including nine DVT’s and six PE’s) 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 the therapy prior to

Conclusion

The incidence of VTE is low. There is significant variability in the strategies used to prevent VTE events after electrophysiology procedures. Future research is required to evaluate strategies to reduce the risk of VTE that may be incorporated into electrophysiology practice guidelines.

Le Fonds de Recherche Santé Québec