Division of Cardiology, Cardio-Thoracic Department, School of Medicine, University Hospital of Verona, Piazzale Aristide Stefani 1, 37126 Verona, Italy.
Department of Cardiology, Ministry of Interior and Administration National Medical Institute, Warsaw, Poland.
Europace. 2023 Dec 28;26(1). doi: 10.1093/europace/euad364.
Limited data are available regarding venous thromboembolism (VTE), specifically deep vein thrombosis (DVT) and pulmonary embolism (PE), following right-sided ablations and electrophysiological (EP) studies. Compared to left-sided procedures, no guidelines on antithrombotic management strategies for the prevention of DVT and PE are available. The main purpose of the present European Heart Rhythm Association (EHRA) survey is to report the current management of right-sided EP procedures, focusing on anticoagulation and prevention of VTE. An online survey was conducted using the EHRA infrastructure. A total of 244 participants answered a 19-items questionnaire on the periprocedural management of EP studies and right-sided catheter ablations. The right femoral vein is the most common access for EP studies and right-sided procedures. An ultrasound-guided approach is employed by more than 2/3 of respondents. Intravenous heparin is not commonly given by the majority of participants. About 1/3 of participants (34%) routinely prescribe VTE prophylaxis during (mostly aspirin and low molecular weight heparin) and 1/4 of respondents (25%) commonly prescribe VTE prophylaxis after discharge (mostly aspirin). Of note, respectively 13% and 9% of participants observed at least one DVT and one PE related to right-sided ablation or EP study within the last year in their center. The present survey shows that only a minority of operators routinely gives intraprocedural intravenous heparin and prescribes VTE prophylaxis after right-sided EP procedures. Compared to left-sided procedures like atrial fibrillation (AF) ablation, there are no consistent systematic antithrombotic management strategies.
有关右侧消融和电生理（EP）研究后静脉血栓栓塞症（VTE），特别是深静脉血栓形成（DVT）和肺栓塞（PE）的数据有限。与左侧手术相比，目前尚无预防 DVT 和 PE 的抗血栓管理策略的指南。本欧洲心律协会（EHRA）调查的主要目的是报告目前右侧 EP 程序的管理情况，重点是抗凝和预防 VTE。使用 EHRA 基础设施进行了在线调查。共有 244 名参与者回答了关于 EP 研究和右侧导管消融术围手术期管理的 19 项问卷。右侧股静脉是 EP 研究和右侧手术最常见的入路。超过 2/3 的受访者采用超声引导方法。大多数参与者没有常规给予静脉内肝素。大约 1/3 的参与者（34%）在手术期间（主要是阿司匹林和低分子肝素）常规进行 VTE 预防，1/4 的受访者（25%）在出院后（主要是阿司匹林）常规进行 VTE 预防。值得注意的是，分别有 13%和 9%的参与者在过去一年中在其中心观察到至少 1 例与右侧消融或 EP 研究相关的 DVT 和 1 例 PE。本调查显示，只有少数操作者常规给予术中静脉内肝素，并在右侧 EP 手术后开具 VTE 预防药物。与左侧手术（如房颤消融）相比，没有一致的系统抗血栓治疗策略。
