Evidence map›Paper›PMID 40522938›Full record

ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025

Vascular access site management during electrophysiology procedures: a European Heart Rhythm Association survey.

Mark T Mills, Dhiraj Gupta, Vishal Luther, Maura M Zylla, Piotr Futyma, Laura Perrotta, Michal Mazurek, Christian-Hendrick Heeger, Lina Marcantoni, Andreas Metzner and 1 more

Abstract read
In one paragraph

Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Vascular closure with a suture retention device versus suture-mediated closure system after large bore venous access for electrophysiologic procedures.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Article
  2. Article
  3. Article
  4. Review
  5. Diversity, equity, and inclusion in arrhythmia care: a European Heart Rhythm Association survey.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  6. Transseptal puncture and catheter ablation of atrial fibrillation in patients with atrial septal occluder devices: procedural techniques and outcomes.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  7. Same-day discharge after electrophysiological and cardiac implantable electronic device procedures: a clinical consensus statement of the European Heart Rhythm Association (EHRA) and the Association of Cardiovascular Nursing & Allied Professions (ACNAP) of the ESC.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Review
  8. [Vascular closure following electrophysiological procedures-a practical guide].Herzschrittmachertherapie & Elektrophysiologie · 2026
    Review
  9. Pulsed field ablation for atrial fibrillation ablation: a European Heart Rhythm Association survey.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mark T MillsLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, William Henry Duncan Building, West Derby Street, Liverpool L7 8XL, UK.ORCID 0000-0002-5425-7739
Dhiraj GuptaLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, William Henry Duncan Building, West Derby Street, Liverpool L7 8XL, UK.ORCID 0000-0002-3490-090X
Vishal LutherLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, William Henry Duncan Building, West Derby Street, Liverpool L7 8XL, UK.ORCID 0000-0003-3274-7128
Maura M ZyllaDepartment of Cardiology, Heidelberg Center of Heart Rhythm Disorders, Medical University Hospital, Im Neuenheimer Feld 410, Heidelberg, Germany.ORCID 0000-0001-9373-8132
Piotr FutymaMedical College, University of Rzeszów and St. Joseph's Heart Rhythm Center, Rzeszów, Poland.ORCID 0000-0003-0219-7612
Laura PerrottaArrhythmia Unit, Department of Cardiology, Careggi University Hospital, Florence, Italy.ORCID 0000-0002-4322-1183
Michal Mazurek1st Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Zabrze, Poland.ORCID 0000-0002-1991-1707
Christian-Hendrick HeegerDepartment of Rhythmology; Cardiology and Internal Medicine, Asklepios Klinik Hamburg Altona, Hamburg, Germany.ORCID 0000-0002-9014-8097
Lina MarcantoniCardiology Department, Santa Maria della Misericordia Hospital, Rovigo, Italy.ORCID 0000-0001-5854-9782
Andreas MetznerDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.ORCID 0000-0002-6818-6396
Julian K R ChunCardioangiologisches Centrum Bethanien, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany.ORCID 0000-0002-2355-6015

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsReliable vascular access and haemostasis techniques are important to the safety of electrophysiology (EP) procedures. This European Heart Rhythm Association (EHRA) survey aimed to evaluate contemporary vascular access site management practices across international EP centres. METHODS AND

resultsA 30-question survey was disseminated via the EHRA between March and April 2025, with 401 responses from professionals across 51 countries. Most respondents were cardiology consultants/attendings (82.0%), with 57.3% performing over 150 EP procedures annually. Ultrasound guidance for vascular access was usually or always used by 71.7%, though 21.4% used it rarely or never, and only 17.3% had received formal ultrasound training. Institutional protocols for haemostasis were lacking in around half (46.8%) of centres. Suture-mediated closure was the most common method for haemostasis (60.4%), followed by manual compression (33.0%) and vascular closure devices (VCDs, 5.8%). The figure-of-eight suture with a hand-tied knot was the most frequently used suture technique (79.7%). Just over a third (36.0%) had experience with VCDs, typically reserved for high-risk cases. For procedures requiring transeptal access, 38.1% administered heparin before transeptal puncture, while protamine was rarely or never used by 62.1%. Anticoagulation was partially interrupted in 52.1% and continued uninterrupted in 41.1% of routine atrial fibrillation (AF) ablations. The median bed rest duration post-procedure ranged from 4 h (right-sided EP procedures) to 6 h (AF or left-sided EP procedures). The average quoted vascular complication risk during consent was 3% (inter-quartile range 1-5%).

conclusionThis survey highlights marked variation in vascular access site management during and following EP procedures, emphasizing the need for further clinical trials to inform best practice and guide future standardization efforts.

Indexed as

Catheter AblationElectrophysiologic Techniques, CardiacHemostatic TechniquesPractice Patterns, Physicians'EuropeHealth Care SurveysHumansPuncturesSuture TechniquesUltrasonography, InterventionalVascular Closure DevicesCatheter ablationComplicationsElectrophysiologyHaemostasisVascular access

Identifiers

PMID40522938
PMCPMC12212052

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.