Meta-analysis of ultrasound-guided vs conventional vascular access for cardiac electrophysiology procedures.

Background: Vascular complications are common during invasive cardiac electrophysiology procedures. This meta-analysis compares outcomes following ultrasound and nonultrasound-guided vascular access for these procedures.

Methods: PubMed, Embase and Cochrane 01/01/1980-30/09/2018 were searched for relevant studies to meta-analyse.

Results: Seven studies (6269 patients) were included. Pooled rates and odds ratio(95% confidence interval) for ultrasound and nonultrasound subgroups were 1.2% vs 3.0%, 0.32 (0.21-0.49) for all vascular complications, with less hematomas and arterial punctures but similar arteriovenous fistulas, pseudoaneurysms or retroperitoneal bleeds.

Conclusion: Ultrasound guidance had less complications due to less hematoma and arterial puncture, and is generally recommended for electrophysiology procedures.