Original Studies Compared to Femoral Venous Access, Upper Extremity Right Heart Catheterization Reduces Time to Ambulation: A Single Center Experience Bernadette Speiser, 1 MSN, Katrina Pearson, 1 BSN, Hui Xie, 2 PhD, Adhir R. Shroff, 1,2 MD, MPH, FACC, FSCAI, and Mladen I. Vidovich, 1,2 * MD, FACC, FSCAI Objectives: To determine ambulation times after right heart catheterization (RHC) via upper extremity access compared to femoral venous access. Background: Transradial coronary angiography has been associated with shorter times to ambulation. We hypothesized that RHC from the upper extremity would be similarly associated with shorter ambulation times when compared to traditional femoral access. Methods: We performed a single-center retrospective analysis of 379 consecutive patients who underwent a variety of diagnostic and interventional left- and right-heart procedures through upper extremity and femoral access sites. Results: The time to ambulation for RHC through the arm veins versus the femoral vein was lower (42.6 min 6 14.2 vs. 175.0 min 6 65.0, P < 0.001). Fluoroscopy times (8.5 min 6 6.8 vs. 12.8 min 6 8.4, P < 0.001) and radiation doses (64.1 Gy cm 22 6 60.0 vs. 108.5 Gy cm 22 6 71.6, P < 0.001) were reduced in the radial compared to femoral group, respectively. In multivariate analyses, upper arm access (P < 0.0001), lower heparin dose (P 5 0.032), inpatient sta- tus (P 5 0.01), and concurrent PCI (P 5 0.03) were associated with shorter times to ambulation. Conclusions: Right heart catheterization from the upper extremity is strongly associated with shorter times to ambulation. V C 2016 Wiley Periodicals, Inc. Key words: right heart catheterization; upper extremity access; time to ambulation INTRODUCTION Radial access for coronary angiography and inter- vention (TRA) has become widely adopted in the last decade due to reduction in vascular access complica- tions, improved patient comfort, decreased recovery times and cost [1]. Traditionally, femoral venous access is used for right heart catheterization (F-RHC) performed in conjunction with femoral coronary angi- ography (TFA). However, RHC can be successfully performed from the arm (A-RHC) thus potentially facilitating patient discharge and improving patient comfort. Compared to the larger femoral veins, upper extremity veins can be easily compressed which sim- plifies hemostasis. Shorter times to hemostasis and shorter time to ambulation would be expected to decrease staff workload and improve hospital econom- ics. Although TRA has been almost invariably associ- ated with shorter times to ambulation [2], little is known about the impact of A-RHC on this measure. Systemic anticoagulation administered during percuta- neous coronary intervention (PCI) further may increase 1 Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, Illinois 2 Division of Epidemiology and Biostatistics, University of Illi- nois at Chicago, Chicago, Illinois Conflict of interest: Nothing to report. *Correspondence to: Mladen I. Vidovich, MD, 840 S Wood Street, MC 715, Chicago, IL 60613. E-mail: miv@uic.edu Additional Supporting Information may be found in the online version of this article. Received 6 January 2016; Revision accepted 22 April 2016 DOI: 10.1002/ccd.26573 Published online 00 Month 2016 in Wiley Online Library (wileyonlinelibrary.com) V C 2016 Wiley Periodicals, Inc. Catheterization and Cardiovascular Interventions 00:00–00 (2016)