4 284

Cited 59 times in

Safety and convenience of continuous warfarin strategy during the periprocedural period in patients who underwent catheter ablation of atrial fibrillation

Authors
 JAE-JIN KWAK  ;  HUI-NAM PAK  ;  JIN-KUN JANG  ;  SOOK KYOUNG KIM  ;  JAE HYUNG PARK  ;  JONG-IL CHOI  ;  CHUN HWANG  ;  YOUNG-HOON KIM 
Citation
 JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Vol.21(6) : 620-625, 2010 
Journal Title
 JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY 
ISSN
 1045-3873 
Issue Date
2010
MeSH
Aged ; Anticoagulants/administration & dosage ; Anticoagulants/therapeutic use* ; Atrial Fibrillation/blood ; Atrial Fibrillation/surgery* ; Blood Loss, Surgical/prevention & control ; Catheter Ablation* ; Electrophysiology ; Female ; Follow-Up Studies ; Heparin/administration & dosage ; Heparin/therapeutic use ; Humans ; International Normalized Ratio ; Intraoperative Complications/epidemiology ; Intraoperative Complications/prevention & control ; Male ; Middle Aged ; Monitoring, Physiologic ; Thromboembolism/prevention & control ; Warfarin/administration & dosage ; Warfarin/therapeutic use*
Keywords
anticoagulation ; atrial fibrillation ; warfarin ; heparin ; catheter ablation
Abstract
BACKGROUND: We investigated the efficiency and convenience of a continuous warfarinization (CW) strategy during the periprocedural period of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) in comparison with the classic strategy of switching to heparin (SH). METHODS AND RESULTS: We compared CW (n = 49) and SH (n = 55, 3 days before RFCA) in 104 patients who underwent RFCA of AF (77 males, 55 +/- 12 years old, paroxysmal AF: persistent AF = 63:41). During the procedure, the activated clotting time (ACT) was maintained between 350 and 400 seconds, and a requirement of H, postablation INR, and periprocedural complications were compared. Results were as follows: (1) in the CW group, the preprocedural INR (1.85 +/- 0.61 vs 1.05 +/- 0.12, P < 0.001) and the proportions of INR > 2.0 after RFCA (1st postprocedure day 61.2% vs 5.5%, P < 0.001; 2nd postprocedure day 83.3% vs 21.8%, P < 0.005) were higher, and the heparin requirement was lower (2012 +/- 998 U/30 minutes vs 2921 +/- 795 U/30 minutes, P < 0.001) than in the SH group. (2) The incidences of hemorrhagic complications (18.2% vs 18.4%, P = NS) or the major bleeding rates (reduced hemoglobin >or= 4 g/dL, requiring blood transfusion; 3.6% vs 12.2%, P = NS) were not significantly different in the CW group than in the SH group. CONCLUSION: The periprocedural CW strategy maintains a more stable INR immediately after AF ablation without increasing hemorrhagic complications compared with the classic strategy of SH. Simple CW can replace SH in an experienced laboratory with a low risk of hemopericardium during AF ablation.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1540-8167.2009.01670.x/abstract
DOI
10.1111/j.1540-8167.2009.01670.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103039
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse