Using point‐of‐care ultrasound to determine incidence of deep vein thrombosis after right‐sided radiofrequency catheter ablation

Abstract

Abstract Introduction Femoral venous access is routinely used for radiofrequency catheter ablation (RFA) procedures. Deep vein thrombosis (DVT), which is often sub‐clinical, is uncommon following RFCA. Point‐of‐care ultrasound (POCUS) is a cost‐effective way to diagnose DVT. Identification of DVT incidence, especially if sub‐clinical, can direct change in practice to reduce DVT and lay ground for cost‐effective screening strategies postprocedures. The aim of our study is to determine the incidence of DVT after right‐sided radiofrequency cardiac catheter ablation using POCUS. Methods We conducted a single‐center prospective cross‐sectional study in patients undergoing right‐sided RFCA. Within 24 h postprocedure, the participants underwent compression venous duplex ultrasonography using POCUS to look for evidence of DVT in cannulated limb. The contralateral limb that was not cannulated was scanned as a control. Results A total of 194 patients were scanned post‐right‐sided RFCA procedures. Average age was 43.5 ± 13.2 years and 131 (67.5%) were women. A total of 148 (76.3%) patients underwent AVNRT ablation. Ten (5.2%) patients developed DVT, of which nine had sub‐clinical DVT. Age (>53 years), greater sum of sheaths used (>3) and longer duration of bed rest maintained (up to 4.0 h vs. >4.0 h, p = 0.006) were identified as risk factors. Conclusion Most of the DVTs after right‐sided catheter ablation are sub‐clinical. Routine scanning for DVT after right‐sided catheter ablation as well as reducing number of sheaths and bed rest should be considered.

Keywords

• complications of cardiac arrhythmias
• deep venous thrombosis (DVT)
• electrophysiology study and radiofrequency catheter ablation
• point‐of‐care ultrasonography (POCUS)