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Exploring factors that influence post procedure bleeding in cardiac ablation patients

May 27, 2023 from 12:35pm EDT to 1:05pm EDT

The use of cardiac ablation for treating arrhythmias has increased significantly in the past two decades with results showing it to be a safe and effective procedure. A short-term risk commonly associated with ablation is access site bleeding. This may be associated with type and complexity of procedure, patient characteristics, anticoagulation management and procedural factors. Little evidence exists to inform post-procedure care and management for care-providers. Without a standardized approach, there is variation in timing of sheath removal, bedrest, use of mechanical clamps and vascular closure devices. This may cause ambulation and discharge delay, increased patient discomfort, and potential for unsafe staffing ratios when bleeding occurs. The purpose of this project was to describe the occurrence of post-procedure bleeding after cardiac ablation and explore relationships between procedural factors and post-procedure groin bleeding. All consecutive patients undergoing any cardiac ablation procedure between January and November 2020 were included. A data collection form was completed by the primary nurse caring for each patient and included baseline, intra and post-procedure characteristics. Of the 142 participants, (median age 62, 37% female) 134 (94%) had radiofrequency ablation. Ambulation delays due to groin bleeding occurred in 26 (18%) patients, with 11 (42%) of those requiring a mechanical clamp and 2-hour bedrest reported in 20 (77%) patients. Apixaban (p=.04) and 2-hour bedrest (p=.02) were predictors of ambulation delay. Results can inform the development of nursing guidelines and careful consideration of pre-procedure anticoagulation and longer post-procedure bedrest may decrease delays in ambulation and facilitate timely discharge from hospital.  

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