Impact on nurse workload and patient satisfaction of atrioventricular junction ablation performed simultaneously with conduction system pacing using a superior approach from the pocket compared with the conventional femoral approach.

This article focuses on comparing the superior approach (SA)—accessing the axillary or subclavian vein from the device pocket—with the conventional femoral access (FA) for performing atrioventricular junction ablation (AVJA) simultaneously with conduction system pacing (CSP) in patients with symptomatic, refractory atrial fibrillation (AF). In a prospective observational study of 119 patients, SA was found to significantly reduce nurse workload both in the electrophysiology laboratory and hospital ward, shorten procedure times, enable earlier patient mobilization and discharge, and improve patient satisfaction compared to FA. The study reported similar safety profiles between the two approaches, with SA potentially lowering complications related to femoral access. These findings suggest that SA is a feasible and effective alternative to FA for AVJA during CSP, with implications for optimizing healthcare resource utilization and patient experience.