Department of Cardiology, Cardiovascular Center, National Hospital Organization Higashihiroshima Medical Center, 513 Jike, Saijo-cho, Higashihiroshima, 739-0041, Japan.
Department of Cardiology, Cardiovascular Center, Onomichi General Hospital, Onomichi, Japan.
J Cardiovasc Transl Res. 2023 Dec;16(6):1439-1446. doi: 10.1007/s12265-023-10417-2. Epub 2023 Aug 1.
We aimed to develop a hemostatic device with physiological evidence that allows ambulation soon after atrial fibrillation (AF) ablation. We measured right femoral vein pressure in 57 participants to clarify why groin post-venipuncture rebleeding often occurs during the transition from supine to sitting under compression bandage application and found that it increased more than threefold when raising the upper body (8.6 ± 4.1 to 27.6 ± 6.9 mmHg; P < 0.001). Based on that data, we created a novel hemostatic belt. Its capability test including 25 participants demonstrated that the belt gave much higher compression pressures on the right groin while sitting than the compression bandage (59.5 ± 14.9 vs. 8.1 ± 4 mmHg; P < 0.001), achieving pressures above the maximum femoral vein pressure in 92% of participants. A randomized trial comparing the belt with compression bandage in 74 AF patients demonstrated that the belt reduced time to ambulation without any rebleeding (340 [92.5-360] vs. 360 [360-360] min; P < 0.001) and satisfied more patients. The novel hemostatic belt provided a much higher compression pressure on the right groin during the sitting position than the conventional compression bandage, achieving a pressure above the maximum femoral vein pressure in 92% of the participants.
我们旨在开发一种具有生理证据的止血装置,使患者在心房颤动 (AF) 消融后能够尽快下地活动。我们测量了 57 名参与者的右股静脉压力,以阐明在应用压迫绷带从仰卧位转为坐姿时股静脉穿刺后出血为何经常发生,并发现当抬高上身时,股静脉压力增加了三倍以上(8.6 ± 4.1 至 27.6 ± 6.9 mmHg;P < 0.001)。基于这些数据,我们发明了一种新型止血带。对 25 名参与者的功能测试表明,与压迫绷带相比,该止血带在坐姿时对右腹股沟的压迫压力更高(59.5 ± 14.9 与 8.1 ± 4 mmHg;P < 0.001),在 92%的参与者中达到了股静脉压力的最大值以上。一项在 74 名 AF 患者中比较止血带和压迫绷带的随机试验表明,止血带可减少下地活动时间,且无再出血发生(340 [92.5-360] 与 360 [360-360] 分钟;P < 0.001),且更能满足患者需求。新型止血带在坐姿时对右腹股沟的压迫压力比传统压迫绷带高得多,在 92%的参与者中达到了股静脉压力的最大值以上。