Vascular closure devices in electrophysiology procedures: Systematic review and meta-analysis.

BACKGROUND: Vascular closure devices (VCDs) have been shown to reduce the time to hemostasis in single-point arterial access sites, but their benefit in electrophysiology (EP) procedures requiring multipoint venous access remains uncertain. OBJECTIVE: This study aimed to perform a systematic review and meta-analysis evaluating the efficacy and safety of VCDs compared with manual compression or figure-of-8 suture for venous hemostasis after EP procedures. METHODS: A systematic search of PubMed, Scopus, and Google Scholar was conducted in June 2025 to identify randomized controlled trials comparing VCDs with manual or figure-of-8 closure in EP procedures. RESULTS: 6 randomized controlled trials including 848 patients (460 treated with VCDs) were analyzed. VCDs significantly reduced hematoma formation (3.4% vs 7.7%; odds ratio, 0.51; 95% confidence interval, 0.25-0.92; P = .03) and a composite outcome of all vascular complications (10.4% vs 17.2%; odds ratio, 0.70; 95% confidence interval, 0.50-0.98; P = .04). Times to hemostasis, ambulation, and disposition were significantly shorter in the VCD group by 5.5, 129, and 84 minutes, respectively. CONCLUSION: VCDs modestly reduce vascular complications and significantly shorten recovery time after EP procedures.