Feasibility and clinical benefits of the double-ProGlide technique for hemostasis after cryoballoon atrial fibrillation ablation with uninterrupted oral anticoagulants

OBJECTIVE To access the efficacy and safety of the double-ProGlide technique for the femoral vein access-site closure in cryoballoon ablation with uninterrupted oral anticoagulants(OAC), and its impact on the electrophysiology laboratory time as well as hospital stay after the procedure in this observational study.METHODS Patients with atrial fibrillation undergoing cryoballoon ablation with uninterrupted OAC at Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China from May 2019 to May 2021 were enrolled in this study.From October 2020, double-ProGlide technique was consistently used for hemostasis(ProGlide group), and before that conventional manual compression was utilized(manual compression group). The occurrence of vascular and groin complications was accessed during the hospital stay and until the three-month follow-up.RESULTS A total of 140 participants(69.30% of male, mean age: 59.21 ± 10.29 years) were evaluated, 70 participants being in each group. Immediate hemostasis was achieved in all the patients with ProGlide closure. No major vascular complications were found in the ProGlide group while two major vascular complications were occurred in the manual compression group. The incidence of any groin complication was obviously higher in subjects with manual compression than patients with ProGlide devices(15.71% vs.2.86%, P = 0.009). In addition, compared with the manual compression group, the ProGlide group was associated with significantly shorter total time in the electrophysiology laboratory [112.0(93.3–128.8) min vs. 123.5(107.3–158.3) min, P = 0.006], time from sheath removal until venous site hemostasis [3.8(3.4–4.2) min vs. 8.0(7.6–8.5) min, P < 0.001], bed rest time [8.0(7.6–8.0) h vs. 14.1(12.0–17.6) h, P < 0.001] and hospital stay after the procedure [13.8(12.5–17.8) h vs. 38.0(21.5–41.0) h, P < 0.001].CONCLUSIONS Utilization of the double-ProGlide technique for hemostasis after cryoballoon ablation with uninterrupted OAC is feasible and safe, which has the clinical benefit in reducing the total electrophysiology laboratory time and the hospital stay length after the procedure.