Electrophysiologic interventions in patients with inferior vena cava filters: Safety and efficacy of the transfemoral approach

OBJECTIVES The purpose of this study was to evaluate the transfemoral venous approach for electrophysiologic interventions in patients with inferior vena cava filters. BACKGROUND Reports have detailed complications associated with obtaining central venous access in patients with inferior vena cava filters. Accordingly, electrophysiologic interventions have been modified or deferred altogether in such patients. METHODS Patients requiring interventions with a transfemoral approach who were at least 3 months post filter insertion underwent fluoroscopically guided insertion and withdrawal of electrode catheters with appropriate follow-up. RESULTS Five patients underwent successful pacing, electrophysiologic study, or radiofrequency ablation using one to three catheters, with no complications attributable to filter placement. CONCLUSIONS Transfemoral electrophysiologic interventions can be safely undertaken across vena cava filters provided appropriate precautions are taken.