Vascular Access Considerations for Electrophysiology Devices

Vascular Access Considerations for Electrophysiology Devices  

Electrophysiology procedures are common – and highly successful – diagnostic and treatment methods for heart rhythm disorders. They require vascular access to reach the heart, so the type of vascular access approach that is taken and the devices used to complete the procedure are crucial to optimizing outcomes.

Femoral access is the standard vascular access approach that is taken but whatever the method, there are risks and other important factors to consider – both safety and ease of access considerations.

It is also important to note that while electrophysiology procedures are low risk, the majority of complications that arise are related to vascular access.

When designing and developing medical device products and components for electrophysiology procedures, it is important to include features and performance characteristics that specifically reduce the risk of vascular access-related complications. This must be achieved without, of course, deviating from the product’s intended use or effectiveness.

The Use of Ultrasound Guided Vessel Puncture and Closure

A common approach in electrophysiology procedures is to use palpation techniques for femoral access. However, the risks of complications developing can be reduced by using ultrasound-guided vessel puncture and closure.

Studies have found that ultrasound-guided vein puncture significantly reduces major vascular complications. Minor complications and inadvertent artery puncture incidents are also reduced. Other benefits include reduced post-procedural groin pain for patients and shorter puncture times.

Crucially, many of the studies found that complications can be reduced with ultrasound-guided vessel puncture compared to landmark-guided approaches regardless of the level of complexity of the electrophysiology procedure.

The Importance of Maneuverability

Vascular access devices developed for electrophysiology procedures must be able to navigate tortuous anatomies and reach areas of the heart that need to be diagnosed and/or treated. Those areas can be in locations in the heart that are difficult to reach.

Therefore, it is important your device is highly maneuverable to not only provide a stable platform, but to also steer the device to the target location.

Torque control (sometimes referred to as torqueability), ideally at a 1:1 ratio, is also an important performance characteristic, as are kink resistance and pushability.

Other Vascular Access Considerations for Electrophysiology Devices

Enabling hemostasis helps to prevent complications related to vascular access, so features such as hemostatic valves can enhance the performance of your electrophysiology device.

Soft distal tips and smooth tip-to-dilator transitions are also beneficial as smooth transitions ensure consistency when crossing anatomical structures. Introducer sheaths should also be able to accommodate the direct delivery of large tip catheters.

Physicians also require varied options so they can choose a device that matches the patient’s anatomy and the procedural approach that has been selected.

Other important considerations include minimizing trauma, ensuring the device is easy for physicians to use, enabling one-person operation of the device, and including features that mitigate clotting, air embolisms, and infection risks.

Supporting Your Electrophysiology Device

If you are an OEM, we can supply high-quality products that will enhance your electrophysiology device. This includes guidewires and hemostasis valve introducers in a range of sizes and configurations. To find out more and to discuss your vascular access device requirements, please get in touch with a member of the Galt team today.