Ultrasound-guided femoral vascular access in adult congenital heart disease patients undergoing catheter ablation on uninterrupted oral anticoagulation

By
Marta Telishevska
Sarah Lengauer
Theresa Reiter
Hannah Krafft
Miruna Popa
Fabian Bahlke
Florian Englert
Nico Erhard
Isabel Deisenhofer
Gabriele Hessling
June 2, 2026
0 min

Clinical Research In Cardiology

Overview

This study evaluates the impact of ultrasound-guided vascular access (UGVA) on vascular complications during catheter ablation in adults with congenital heart disease (ACHD) on continuous oral anticoagulation. The findings suggest a significant reduction in vascular complications following the implementation of UGVA compared to conventional methods.

Background

Cardiac arrhythmias in ACHD patients are increasingly prevalent due to an aging population and earlier onset of arrhythmias. Catheter ablation is recommended as a first-line therapy, but the unique anatomy and history of previous surgeries in these patients pose significant challenges. Vascular complications are common, particularly in patients on anticoagulation, necessitating improved access strategies.

Data Highlights

{'UGVA': {'Major Complications': 'Data needed', 'Minor Complications': 'Data needed'}}

Key Findings

Major vascular complications in ACHD patients on uninterrupted oral anticoagulation were previously reported at 1.1% with conventional access.
Minor complications were observed at a rate of 12.5% in the same cohort.
UGVA was implemented in 2020, resulting in a shift in practice for vascular access.
The UGVA group had fewer ablation procedures per patient compared to the conventional group.
Ultrasound guidance allows for better visualization of vascular anatomy, potentially reducing complications.
Recent guidelines recommend routine ultrasound guidance for femoral venous access in electrophysiological interventions.

Clinical Implications

The adoption of ultrasound-guided vascular access in ACHD patients undergoing catheter ablation may significantly reduce the risk of vascular complications. Clinicians should consider integrating UGVA into their practice to enhance patient safety, particularly in those on anticoagulation therapy.

Conclusion

The transition to ultrasound-guided vascular access represents a promising advancement in the management of ACHD patients undergoing catheter ablation, with the potential to improve safety outcomes.