Early Heparin Administration Reduces Risk for Left Atrial Thrombus Formation during Atrial Fibrillation Ablation Procedures

Objective. Despite the use of anticoagulation during left atrial (LA) ablation procedures, ischemic cerebrovascular accidents (CVAs) are recognized as a serious complication. Heparin is usually given after safe transseptal access has been obtained, resulting in a short unprotected dwell time of cath...

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Main Authors: Stefan Asbach, Jürgen Biermann, Christoph Bode, Thomas S. Faber
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.4061/2011/615087
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author Stefan Asbach
Jürgen Biermann
Christoph Bode
Thomas S. Faber
author_facet Stefan Asbach
Jürgen Biermann
Christoph Bode
Thomas S. Faber
author_sort Stefan Asbach
collection DOAJ
description Objective. Despite the use of anticoagulation during left atrial (LA) ablation procedures, ischemic cerebrovascular accidents (CVAs) are recognized as a serious complication. Heparin is usually given after safe transseptal access has been obtained, resulting in a short unprotected dwell time of catheters within the LA, which may account for CVAs. We investigated the frequency of CVAs and LA thrombus formation as detected by intracardiac ultrasound (ICE) depending on the timing of heparin administration. Methods and Results. Sixty LA ablation procedures with the use of ICE were performed in 55 patients. Patients were grouped by heparin administration after (Group I, 𝑛=13) and before (Group II, 𝑛=47) transseptal access. Group I patients were younger (56.6±13.7 versus 65.9±9.9 years, 𝑃=.01); other clinical and echocardiographic characteristics did not differ between groups. Early thrombus formation was observed in 2 (15.4%) of group I patients as compared to 0% of group II patients (𝑃=.04). One CVA (2.1%) occurred in one group II patient without prior thrombus detection, and none occurred in group I patients (𝑃=ns). Conclusion. Early administration of heparin reduces the risk of early intracardiac thrombus formation during LA ablation procedures. This did not result in reduced rate of CVAs.
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spelling doaj-art-3d53e46cbb6c473c9048a720195a838a2025-02-03T06:08:29ZengWileyCardiology Research and Practice2090-05972011-01-01201110.4061/2011/615087615087Early Heparin Administration Reduces Risk for Left Atrial Thrombus Formation during Atrial Fibrillation Ablation ProceduresStefan Asbach0Jürgen Biermann1Christoph Bode2Thomas S. Faber3Department of Cardiology and Angiology, University Hospital Freiburg, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Cardiology and Angiology, University Hospital Freiburg, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Cardiology and Angiology, University Hospital Freiburg, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Cardiology and Angiology, University Hospital Freiburg, Hugstetter Straße 55, 79106 Freiburg, GermanyObjective. Despite the use of anticoagulation during left atrial (LA) ablation procedures, ischemic cerebrovascular accidents (CVAs) are recognized as a serious complication. Heparin is usually given after safe transseptal access has been obtained, resulting in a short unprotected dwell time of catheters within the LA, which may account for CVAs. We investigated the frequency of CVAs and LA thrombus formation as detected by intracardiac ultrasound (ICE) depending on the timing of heparin administration. Methods and Results. Sixty LA ablation procedures with the use of ICE were performed in 55 patients. Patients were grouped by heparin administration after (Group I, 𝑛=13) and before (Group II, 𝑛=47) transseptal access. Group I patients were younger (56.6±13.7 versus 65.9±9.9 years, 𝑃=.01); other clinical and echocardiographic characteristics did not differ between groups. Early thrombus formation was observed in 2 (15.4%) of group I patients as compared to 0% of group II patients (𝑃=.04). One CVA (2.1%) occurred in one group II patient without prior thrombus detection, and none occurred in group I patients (𝑃=ns). Conclusion. Early administration of heparin reduces the risk of early intracardiac thrombus formation during LA ablation procedures. This did not result in reduced rate of CVAs.http://dx.doi.org/10.4061/2011/615087
spellingShingle Stefan Asbach
Jürgen Biermann
Christoph Bode
Thomas S. Faber
Early Heparin Administration Reduces Risk for Left Atrial Thrombus Formation during Atrial Fibrillation Ablation Procedures
Cardiology Research and Practice
title Early Heparin Administration Reduces Risk for Left Atrial Thrombus Formation during Atrial Fibrillation Ablation Procedures
title_full Early Heparin Administration Reduces Risk for Left Atrial Thrombus Formation during Atrial Fibrillation Ablation Procedures
title_fullStr Early Heparin Administration Reduces Risk for Left Atrial Thrombus Formation during Atrial Fibrillation Ablation Procedures
title_full_unstemmed Early Heparin Administration Reduces Risk for Left Atrial Thrombus Formation during Atrial Fibrillation Ablation Procedures
title_short Early Heparin Administration Reduces Risk for Left Atrial Thrombus Formation during Atrial Fibrillation Ablation Procedures
title_sort early heparin administration reduces risk for left atrial thrombus formation during atrial fibrillation ablation procedures
url http://dx.doi.org/10.4061/2011/615087
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AT jurgenbiermann earlyheparinadministrationreducesriskforleftatrialthrombusformationduringatrialfibrillationablationprocedures
AT christophbode earlyheparinadministrationreducesriskforleftatrialthrombusformationduringatrialfibrillationablationprocedures
AT thomassfaber earlyheparinadministrationreducesriskforleftatrialthrombusformationduringatrialfibrillationablationprocedures