Research progress on factors influencing early mobilization and strategies to promote it in patients following cardiac electrophysiological interventions

doi:10.3761/j.issn.0254-1769.2026.16.017

Abstract

Abstract:

The safe implementation of early activity for patients after cardiac electrophysiological interventions is influenced by the effectiveness of femoral vascular access-site hemostasis and closure，sheath size，anticoagulation status，and the risk of vascular complications. This article provides a review of manual compression combined with pressure bandaging，figure-of-eight suture，and the use of vascular closure devices，as well as the appropriate scenarios，limitations，and key decision-making factors for these different strategies. It also offers recommendations regarding surgical techniques and risk stratification，key nursing observation points，guidance on phased early mobilization，and follow-up care，aiming to provide a reference for the safe implementation of early activity and the optimization of nursing decision-making for patients after cardiac electrophysiological interventions.

Key words: Cardiac Electrophysiological Intervention, Early Activity, Femoral Vessels, Hemostasis and Closure, Review, Nursing Care

摘要：

心脏电生理介入术后患者早期活动的安全实施受股血管穿刺部位止血闭合效果、鞘管规格、抗凝状态及血管并发症风险等因素影响。该文对手动压迫联合加压包扎、“8”字缝合、使用血管闭合装置，以及不同策略的适用场景、局限与决策要点进行综述，并从术式与风险分层、护理观察重点、分阶段早期活动指导及延续性护理等方面提出建议，以期为心脏电生理介入术后患者早期活动的安全实施和护理决策优化提供参考。

关键词: 心脏电生理介入, 早期活动, 股血管, 止血闭合, 综述, 护理

DAI Wei, LU Jianrong, ZHANG Lei, ZHAI Ying, ZHANG Jiajia, BAO Qing. Research progress on factors influencing early mobilization and strategies to promote it in patients following cardiac electrophysiological interventions[J]. Chinese Journal of Nursing, 2026, 61(16): 2277-2282.

戴薇, 陆剑嵘, 张蕾, 翟颖, 张佳佳, 鲍青. 心脏电生理介入术后患者早期活动影响因素及促进策略的研究进展[J]. 中华护理杂志, 2026, 61(16): 2277-2282.

References 37

[1]	Mao YJ, Feng WY, Huang QY, et al. Meta-analysis of cryobal-loon ablation versus antiarrhythmic drugs as initial therapy for symptomatic atrial fibrillation[J]. Clin Cardiol, 2021, 44(10):1393-1401. DOI URL
[2]	Mills MT, Gupta D, Luther V, et al. Vascular access site mana-gement during electrophysiology procedures:a European Heart Rhythm Association survey[J]. Europace, 2025, 27(7):euaf117. DOI URL
[3]	Morillo CA, Verma A, Connolly SJ, et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of paroxysmal atrial fibrillation(RAAFT-2):a randomized trial[J]. JAMA, 2014, 311(7):692. DOI PMID
[4]	De Potter TJR, Valeriano C, Akerstrom F, et al. Vascular access and closure management for electrophysiological interventions in 2025:a clinical consensus statement of the European Heart Rhythm Association and the European Association of Percuta-neous Cardiovascular Interventions of the ESC,and the ESC Working Group on cardiovascular surgery[J]. Europace, 2025, 27(10):euaf115. DOI URL
[5]	Tabaja C, Hight N, Younis A, et al. Vascular access complica-tions after catheter ablation of ventricular arrhythmias:impact of vascular closure devices[J]. Heart Rhythm, 2025, 22(3):685-692. DOI URL
[6]	Benali K, Khairy P, Hammache N, et al. Procedure-related com-plications of catheter ablation for atrial fibrillation[J]. J Am Coll Cardiol, 2023, 81(21):2089-2099. DOI PMID
[7]	Natale A, Mohanty S, Liu PY, et al. Venous vascular closure system versus manual compression following multiple access electrophysiology procedures:the ambulate trial[J]. JACC Clin Electrophysiol, 2020, 6(1):111-124. DOI URL
[8]	王琳, 胡玉芳, 孙国珍, 等. 心房颤动患者导管消融术后肢体制动与卧床时间研究[J]. 护理学杂志, 2015, 30(11):29-31.
	Wang L, Hu YF, Sun GZ, et al. Limb immobilization and be-dridden time after catheter ablation for patients with atrial fibrillation[J]. J Nurs Sci, 2015, 30(11):29-31.
[9]	Shanker AJ, Jones SO, Blankenship JC, et al. HRS/ACC scienti-fic statement:guiding principles on same-day discharge for in-tracardiac catheter ablation procedures[J]. Heart Rhythm, 2025, 22(6):e1-e12. DOI URL
[10]	中华医学会心电生理和起搏分会, 中国医师协会心律学专业委员会. 中国心房颤动管理指南(2025)[J]. 中国心脏起搏与心电生理杂志, 2025, 39(4):273-343.
	Chinese Society of Cardiac Pacing and Electrophysiology,Chinese Medical Association; Arrhythmia Committee,Chinese Medical Doctor Association. Chinese guidelines for the mana-gement of atrial fibrillation(2025)[J]. Chin J Cardiac Pacing Electrophy, 2025, 39(4):273-343.
[11]	刘君. 8字缝合用于经股静脉入路导管消融术后止血的疗效与安全性[D]. 南昌: 南昌大学, 2023.
	Liu J. Efficacy and safety of figure-of-eight suture for hemo-stasis after catheter ablation via the femoral venous approach[D]. Nanchang: Nanchang University, 2023.
[12]	Bin Waleed K, Leung LW, Akhtar Z, et al. New approaches to achieving hemostasis after venous access in cardiovascular patients[J]. Kardiol Pol, 2022, 80(7/8):750-759. DOI URL
[13]	Geis NA, Pleger ST, Chorianopoulos E, et al. Feasibility and clinical benefit of a suture-mediated closure device for fe-moral vein access after percutaneous edge-to-edge mitral valve repair[J]. EuroIntervention, 2015, 10(11):1346-1353. DOI URL
[14]	Tazreean R, Nelson G, Twomey R. Early mobilization in en-hanced recovery after surgery pathways:current evidence and recent advancements[J]. J Comp Eff Res, 2022, 11(2):121-129. DOI URL
[15]	Puliyakkuth U, Ramamoorthy L, Selvaraj RJ, et al. Effect of early ambulation on comfort and vascular complications follow-ing electrophysiological studies:a randomized controlled trial[J]. J Educ Health Promot, 2024, 13(1):292.
[16]	Alharazi RM, Alqahtani RH, Alanazi RA, et al. Knowledge and practices regarding deep venous thrombosis(DVT) prevention among nurses in Jeddah,Saudi Arabia[J]. Nurs Rep, 2024, 14(4):3955-3967. DOI URL
[17]	毛越, 何杰, 湛扬, 等. 1例超高龄患者行经导管主动脉瓣置换术后合并心律失常的护理[J]. 中华护理杂志, 2024, 59(21):2649-2653. DOI
	Mao Y, He J, Zhan Y, et al. Nursing care of a super elderly patient with arrhythmia after transcatheter aortic valve repla-cement[J]. Clin J Nurs, 2024, 59(21):2649-2653.
[18]	刘建萍, 郭卫婷, 高伟, 等. 心脏康复患者运动恐惧体验质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(4):474-481. DOI
	Liu JP, Guo WT, Gao W, et al. Meta-synthesis of qualitative research on the experience of kinesiophobia in patients with cardiac rehabilitation[J]. Chin J Nurs, 2024, 59(4):474-481. DOI
[19]	Alhassoon A, Alharazi R, Almutary H. Nurses’ knowledge,atti-tude and practice toward immobility complications:a scoping review[J]. BMC Nurs, 2026, 25(1):429. DOI
[20]	祝海香, 王云鹤, 韩小雪, 等. 心脏加速康复方案在心房颤动行导管射频消融术患者中的应用研究[J]. 中华急危重症护理杂志, 2023, 4(1):22-28.
	Zhu HX, Wang YH, Han XX, et al. Application of cardiac enhanced rehabilitation management protocol in patients under-going radiofrequency catheter ablation for atrial fibrillation[J]. Chin J Emerg Crit Care Nurs, 2023, 4(1):22-28.
[21]	黄淑萍, 龚蓓, 申铁梅, 等. 心房颤动患者介入手术围术期护理专家共识[J]. 中华介入放射学电子杂志, 2024, 12(1):1-9.
	Huang SP, Gong B, Shen TM, et al. Expert consensus on perioperative nursing care of patients with atrial fibrillation undergoing interventional surgery[J]. Chin J Interv Radiol Ele-ctron Ed, 2024, 12(1):1-9.
[22]	Cilingiroglu M, Salinger M, Zhao D, et al. Technique of tempo-rary subcutaneous “Figure-of-Eight” sutures to achieve hemo-stasis after removal of large-caliber femoral venous sheaths[J]. Cathet Cardio Intervent, 2011, 78(1):155-160.
[23]	Matsunaga-Lee Y, Egami Y, Yanagawa K, et al. Limited effi-cacy of a figure-of-eight suture for hemostasis after cryobal-loon atrial fibrillation ablation with uninterrupted oral anti-coagulants[J]. J Cardiol, 2020, 76(1):30-34. DOI PMID
[24]	Tilz RR, Feher M, Vogler J, et al. Venous vascular closure system vs. figure-of-eight suture following atrial fibrillation abla-tion:the STYLE-AF Study[J]. Europace, 2024, 26(5):euae105. DOI URL
[25]	Pang ND, Gao J, Zhang BH, et al. Vascular closure devices versus manual compression in cardiac interventional proce-dures:systematic review and meta-analysis[J]. Cardiovasc Ther, 2022, 2022:8569188.
[26]	Upadhaya S, Upreti A, Gupta K, et al. Vascular closure de-vices for large bore femoral access after transfemoral trans-catheter aortic valve replacement:a network meta-analysis[J]. Catheter Cardiovasc Interv, 2025, 106(1):423-432.
[27]	Robertson L, Andras A, Colgan F, et al. Vascular closure devi-ces for femoral arterial puncture site haemostasis[J]. Cochrane Database Syst Rev, 2016, 3(3):CD009541.
[28]	Ali M, Masood F, Erickson L, et al. Suture closure AFtEr large bore vein access(SAFE-VEIN):a randomized,prospective study of the efficacy and safety of venous closure device[J]. Cathe-ter Cardiovasc Interv, 2024, 104(4):820-828.
[29]	Fabbricatore D, Buytaert D, Valeriano C, et al. Ambulatory pul-monary vein isolation workflow using the Perclose ProGlide? Suture-mediated vascular closure device:the PRO-PVI study[J]. Europace, 2023, 25(4):1361-1368. DOI PMID
[30]	Shafique MA, Nagra HM, Farooq A, et al. Impact of venous closure systems on time to ambulation and discharge follow-ing AF ablation:a systematic review and meta-analytic review[J]. Egypt Heart J, 2025, 77(1):88. DOI
[31]	谢宜芸, 秦永林. 血管缝合器在股动脉大口径穿刺入路闭合中的临床应用[J]. 介入放射学杂志, 2023, 32(2):196-200.
	Xie YY, Qin YL. Clinical application of suture-mediated closure device in closing the femoral artery puncture access[J]. J Interv Radiol, 2023, 32(2):196-200.
[32]	Vincent F, Spillemaeker H, Kyheng M, et al. Ultrasound gui-dance to reduce vascular and bleeding complications of percutaneous transfemoral transcatheter aortic valve replace-ment:a propensity score-matched comparison[J]. J Am Heart Assoc, 2020, 9(6):e014916. DOI URL
[33]	Foerschner L, Erhard N, Dorfmeister S, et al. Ultrasound-guided access reduces vascular complications in patients undergoing catheter ablation for cardiac arrhythmias[J]. J Clin Med, 2022, 11(22):6766. DOI URL
[34]	郑晓敏, 蔡英华, 周海琴, 等. 快速康复外科理念在肺移植患者围手术期中应用的范围综述[J]. 中华护理杂志, 2022, 57(16): 2018-2024.
	Zheng XM, Cai YH, Zhou HQ, et al. The application of enhanced recovery after surgery concept in the perioperative period of lung transplantation patients:a scoping review[J]. Chin J Nurs, 2022, 57(16):2018-2024.
[35]	National Institute for Health and Care Excellence. Periope-rative care in adults[EB/OL].(2020-08-19)[2026-01-27]. https://www.nice.org.uk/guidance/ng180.
[36]	Espinosa T, Farrus A, Venturas M, et al. Same-day discharge after atrial fibrillation ablation under a nurse-coordinated standardized protocol[J]. Europace, 2024, 26(4):euae083. DOI URL
[37]	张浩, 许官学, 王漫, 等. 数字健康技术在急性心肌梗死患者居家心脏康复中的研究进展[J]. 中华护理杂志, 2025, 60(3):373-379.
	Zhang H, Xu GX, Wang M, et al. Advances in digital health technology in home-based cardiac rehabilitation for patients with acute myocardial infarction[J]. Chin J Nurs, 2025, 60(3):373-379.