Combination of Skin Adhesives and Vascular Closure Device for Complete Hemostasis After Catheter Ablation

Despite the use of vascular closure devices (VCDs) following catheter ablation for atrial fibrillation (AF) effectively shortening postprocedural immobilization time, they carry the risk of subcutaneous hemorrhage, which often requires extended bed rest, exceeding 2 h. We assessed whether combining skin adhesives (SAs) with a VCD can safely enable earlier mobilization without increasing bleeding risk.

This retrospective analysis evaluated 244 patients who underwent catheter ablation for AF between April 2022 and March 2024 and achieved successful hemostasis with a VCD. Patients with cardiac surgery history, dual antiplatelet therapy, cognitive impairment, or intensive care needs were excluded. Ultrasound-guided VCDs were used in all procedures. The SA group (n=162) received Dermabond Mini® with immediate post-anesthesia mobilization. The control group (n=82) underwent angio-roll compression and followed physician-guided rest protocols. Endpoints included rest duration, total procedural time, hemorrhagic events, opioid administration, and length of hospital stay. Despite immediate post-anesthesia mobilization, the SA group showed shorter time to ambulation (129±95 vs. 513±440 min, P<0.01) with lower rates of hemorrhagic complications (BARC type 1: 1.2% vs. 6.1%, P=0.044; BARC type 2: 5.6% vs. 23.2%, P<0.01) than the control group. Procedural duration was comparable. The SA group required less fentanyl.

The combination of SA and VCDs enabled immediate post-anesthesia mobilization without increasing bleeding complications, improving patient outcomes and resource utilization.