• Daniel Rodríguez Muñoz, Eduardo Franco Díez, Javier Moreno, Giuseppe Lumia, Alejandra Carbonell San Román, Teresa Segura De La Cal, Roberto Matía Francés, Antonio Hernández Madrid, and José Luis Zamorano Gómez.
• From the Department of Cardiology, Ramón y Cajal University Hospital, Madrid, Spain.
• Pacing Clin Electrophysiol. 2015 Sep 1; 38 (9): 1058-65.

BackgroundUltrasound (US) guidance increases safety and efficacy in vascular cannulation and is considered the standard of care. However, barriers including workflow interference and the need to be assisted by a second operator limit its adoption in clinical routine. The use of wireless US (WUS) may overcome these barriers. The aim of this study was to assess the impact of a novel WUS probe during its initial implantation in an electrophysiology (EP) laboratory.MethodsThirty-six patients requiring femoral venous cannulation for EP procedures were included in this single center, prospective, observational study, comparing WUS guidance with the anatomical landmark approach. The primary endpoint was time to successful cannulation. Secondary endpoints included rate of unsuccessful punctures, accidental arterial punctures, and workflow interference.ResultsCompared with anatomical landmark approach, WUS guidance significantly reduced mean time to successful cannulation (87.3 ± 94.3 vs 238.1 ± 294.7 seconds, P < 0.01). Workflow interference was predominantly nonexistent or mild and decreased after the first three weeks of use. In addition, WUS guidance improved safety and efficacy, reducing the rate of accidental arterial punctures (0.02 ± 0.1 vs 0.25 ± 0.5 arterial punctures per cannulation, P < 0.05) and unsuccessful attempts (0.26 ± 0.8 vs 1.75 ± 2.1 attempts per cannulation, P < 0.01).ConclusionsWUS guidance resulted in faster, safer, and more effective femoral venous cannulation than the anatomical landmark approach without adding significant workflow interference. The application of wireless technology in this setting contributed to overcoming some of the barriers preventing a more widespread clinical use of US guidance.© 2015 Wiley Periodicals, Inc.

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