Abstract 20619: Feasibility of Ultrasound Guided Vascular Access for Implantable Cardiac Devices
Introduction: Ultrasound (US) guided access for venous catheter placement has previously been shown to improve success rates and decrease access-related complications. Little is known about the feasibility of US guidance for direct vein visualization during device implant.
Hypothesis: Use of US guided access for implantable cardiac devices is effective and correlates with lower fluoroscopy times and reduced complications.
Methods: Following IRB approval, clinical data from 817 patients who underwent new device implants between May 2013 and April 2015 at our institution were reviewed. A complication was defined as DVT, pneumothorax or hematoma. Spearman correlation coefficients, multiple logistic regression and multiple linear regression models adjusted for known confounders were used. A priori significance level of p<0.05 was chosen.
Results: Eight hundred seventeen patients were included: 37% female, 71% HTN, 30% DM, and 37% CAD. No cross over between US guidance and traditional access. Complication rate was 3.6% (2.2% in US vs 3.8% in non-US). The use of US was correlated to a decrease in fluoro time (r=-0.17, p < 0.01), but not major outcomes (r= -0.03, p=0.34). In models adjusted for age and number of leads, use of US non-significantly associated with a change in fluoro time (beta= -0.20, p=0.87). In logistic models adjusted for age, use of US was non-significantly associated with reduced major complications. (Odds ratio = 0.56 , 95% confidence interval 0.17-1.89, p = 0.35).
Conclusions: This is the first study to evaluate the feasibility of US guided vascular access for cardiac implantable devices. Ultrasound guidance is an effective means for obtaining access for cardiac device implantation and correlates with a non-significant reduction in both fluoro time and procedural complications. The present study is underpowered to reach statistical significance due to the low complication rate; the data re-enforces the need for additional studies.
Author Disclosures: J. Lin: None. G. Adsit: None. A. Barnett: None. M. Tattersall: None. J. Wright: None.
- © 2016 by American Heart Association, Inc.