Editorial Comment: Ambulation following cardiac catheterization: the earlier the better

Despite recent reductions in the incidence of vascular complications following femoral artery cardiac catheterization, access site bleeding, arteriovenous fistula and pseudoaneurysm formation continue to impact patient morbidity, length of stay, and health care costs (1, 2). Procedural factors that influence the risk of vascular complications include sheath size, anticoagulation and antiplatelet strategy, and site of entry. Patient factors associated with an increased risk of vascular complications include hypertension, female sex, bleeding diathesis, peripheral arterial disease (PAD), age and obesity (2). Manual compression hemostasis followed by bed rest has been the standard of care following cardiac catheterization via femoral access. However, there are no guidelines on optimal duration of bed rest following the procedure. Studies have shown that early ambulation does not increase the risk of vascular complications and improves patient comfort (3-5). Furthermore, patients who are allowed to move in the bed during their bed rest experience less back and puncture site pain, and have no increase in vascular complications compared to controls (6). Despite this evidence, prolonged bed rest following femoral cardiac catheterization remains the standard of care in many practices.