Fehmi Keçe

Chapter 2 54 2.8.6 Groin complications and bleeding Management of coagulation is important to prevent vascular complications. In addition, a three-point strategy tested in 324 patients with continued warfarin during ablation, a smaller needle for access (18G instead of 21G) and avoiding arterial access has resulted in a reduction in vascular access complications (3.7%vs.0%; p=0.03), while the rates of thromboembolic complications and cardiac tamponade were similar (159). Ultrasound- guided vs. conventional femoral puncture did not reduced major complication rate (0.6vs.1.9%; p=0.62) in 320 patients, however it was associated with significantly lower puncture time, higher rate of first pass success and less extra or arterial punctures (160).