Benedict M Wiles1, Nicholas Child2, Paul R Roberts2. 1. Cardiac Rhythm Management Department, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK. benedict.wiles@uhs.nhs.uk. 2. Cardiac Rhythm Management Department, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK.
Abstract
PURPOSE: Bedside vascular ultrasound machines are increasingly available. They are used to facilitate safer vascular access across a number of different specialties. In the electrophysiology laboratory however, where patients are frequently anticoagulated and require the insertion of multiple venous sheaths, anatomical landmark techniques predominate. Despite the high number of vascular complications associated with electrophysiological procedures and the increasing evidence to support its use in electrophysiology, ultrasound remains underutilised. A new standard of care is required. A comprehensive technical report, providing a detailed explanation of this important technique, will provide other electrophysiology centres with the knowledge and justification for adopting ultrasound guidance as their standard practice. METHOD: We review the increasing body of evidence which demonstrates that routine ultrasound usage can substantially improve the safety of femoral venous access in the electrophysiology laboratory. We offer a comprehensive technical report to guide operators through the process of ultrasound-guided venous access, with a specific focus on the electrophysiology laboratory. Additionally, we detail a novel technique which utilises real-time colour Doppler ultrasound to accurately identify needle tip location during venous puncture. CONCLUSIONS: The use of vascular ultrasound to guide femoral venous cannulation is rapid, inexpensive and easily learnt. Ultrasound is readily available and offers the potential to significantly reduce vascular complications in the unique setting of the electrophysiology laboratory. Ultrasound guidance to achieve femoral venous access should be the new standard of care in electrophysiology.
PURPOSE: Bedside vascular ultrasound machines are increasingly available. They are used to facilitate safer vascular access across a number of different specialties. In the electrophysiology laboratory however, where patients are frequently anticoagulated and require the insertion of multiple venous sheaths, anatomical landmark techniques predominate. Despite the high number of vascular complications associated with electrophysiological procedures and the increasing evidence to support its use in electrophysiology, ultrasound remains underutilised. A new standard of care is required. A comprehensive technical report, providing a detailed explanation of this important technique, will provide other electrophysiology centres with the knowledge and justification for adopting ultrasound guidance as their standard practice. METHOD: We review the increasing body of evidence which demonstrates that routine ultrasound usage can substantially improve the safety of femoral venous access in the electrophysiology laboratory. We offer a comprehensive technical report to guide operators through the process of ultrasound-guided venous access, with a specific focus on the electrophysiology laboratory. Additionally, we detail a novel technique which utilises real-time colour Doppler ultrasound to accurately identify needle tip location during venous puncture. CONCLUSIONS: The use of vascular ultrasound to guide femoral venous cannulation is rapid, inexpensive and easily learnt. Ultrasound is readily available and offers the potential to significantly reduce vascular complications in the unique setting of the electrophysiology laboratory. Ultrasound guidance to achieve femoral venous access should be the new standard of care in electrophysiology.
Authors: Christopher A Troianos; Gregg S Hartman; Kathryn E Glas; Nikolaos J Skubas; Robert T Eberhardt; Jennifer D Walker; Scott T Reeves Journal: J Am Soc Echocardiogr Date: 2011-12 Impact factor: 5.251
Authors: Christian Sticherling; Francisco Marin; David Birnie; Giuseppe Boriani; Hugh Calkins; Gheorghe-Andrei Dan; Michele Gulizia; Sigrun Halvorsen; Gerhard Hindricks; Karl-Heinz Kuck; Angel Moya; Tatjana Potpara; Vanessa Roldan; Roland Tilz; Gregory Y H Lip Journal: Europace Date: 2015-06-23 Impact factor: 5.214
Authors: Jeffrey Lin; Graham Adsit; Anne Barnett; Matthew Tattersall; Michael E Field; Jennifer Wright Journal: J Interv Card Electrophysiol Date: 2017-07-27 Impact factor: 1.900
Authors: Rahel Zuercher; Anique Herling; Marc T Schmidt; Marta Bachmann; Stephan Winnik; Firat Duru; Urs Eriksson Journal: J Clin Med Date: 2022-05-01 Impact factor: 4.964