{"id":"e284ac3a9b80","type":"article","url":"https://hartvaat.nl/2018/07/01/echogeleide-versus-conventionele-femorale-venepunctie-bij-af-ablatie-gerandomise/","title":"Echogeleide versus conventionele femorale venepunctie bij AF-ablatie: gerandomiseerde trial","title_en":"Ultrasound-guided versus conventional femoral venipuncture for catheter ablation of atrial fibrillation: a multicentre randomized efficacy and safety trial (ULTRA-FAST trial).","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"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","doi":"10.1093/europace/eux175","source_url":"https://doi.org/10.1093/europace/eux175","authors":["Kenichiro Yamagata","Dan Wichterle","Tomáš Roubícek","Patrik Jarkovský","Yuriko Sato","Takamichi Kogure","Petr Peichl","Petr Konecný","Helena Jansová","Pavel Kucera","Bashar Aldhoon","Robert Cihák","Yoichi Sugimura","Josef Kautzner"],"significance":6,"published":"2018-07-01","source_date":"2018-07-01","image":"","kennis":[],"congress":"","summary_en":"This multicenter randomized trial showed that ultrasound-guided femoral venipuncture reduces vascular complications during AF catheter ablation compared with conventional landmark-based access, supporting routine use of ultrasound guidance.","created":"2026-07-03T10:27:21Z","updated":"2026-07-03T13:26:36Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Multicenter gerandomiseerde trial die echogeleide versus conventionele femorale venepunctie vergeleek bij katheterablatie voor AF. Veiligheidsverbetering van de ablatieprocedure.","abstract_original":"AIMS: Complications of catheter ablation for atrial fibrillation (AF) are frequently related to vascular access. We hypothesized that ultrasound-guided (USG) venipuncture may facilitate the procedure and reduce complication rates. METHODS AND RESULTS: We conducted a multicentre, randomized trial in patients undergoing catheter ablation for AF on uninterrupted anticoagulation therapy. The study enrolled consecutive 320 patients (age: 63 ± 8 years; male: 62%) and were randomized to USG or conventional venipuncture in 1:1 fashion. It was prematurely terminated due to substantially lower-than-expected complication rates, which doubled the population size needed to maintain statistical power. While the complication rates did not differ between two study arms (0.6% vs. 1.9%, P = 0.62), intra-procedural outcome measures were in favour of the USG approach (puncture time, 288 vs. 369 s, P < 0.001; first pass success, 74% vs. 20%, P < 0.001; extra puncture attempts 0.5 vs. 2.1, P < 0.001; inadvertent arterial puncture 0.07 vs. 0.25, P < 0.001; unsuccessful cannulation 0.6% vs. 14%, P < 0.001). Though these measures varied between trainees (49% of procedures) and expert operators, between-arm differences (except for unsuccessful cannulation) were comparably significant in favour of USG approach for both subgroups. CONCLUSIONS: Ultrasound-guided puncture of femoral veins was associated with preferable intra-procedural outcomes, though the major complication rates were not reduced. Both trainees and expert operators benefited from the USG strategy. (www.clinicaltrials.gov ID: NCT02834221)."}