Safety of Lower Activated Clotting Times During Atrial Fibrillation Ablation Using Open Irrigated Tip Catheters and a Single Transseptal Puncture

Guidelines largely based on closed-tip catheters recommend activated clotting times (ACTs) >300 to 350 seconds during atrial fibrillation (AF) ablation to prevent thrombus and char formation. Open irrigated tip catheters (OITC) may decrease complications and permit lower ACTs. This study evaluate...

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Bibliographic Details
Published in:The American journal of cardiology 2011-03, Vol.107 (5), p.704-708
Main Authors: Winkle, Roger A., MD, Mead, R. Hardwin, MD, Engel, Gregory, MD, Patrawala, Rob A., MD
Format: Article
Language:English
Subjects:
Aged
Atrial Fibrillation - blood
Atrial Fibrillation - diagnostic imaging
Atrial Fibrillation - surgery
Atrial Septum - surgery
Biological and medical sciences
Blood Coagulation - physiology
Cardiac arrhythmia
Cardiac dysrhythmias
Cardiology
Cardiology. Vascular system
Cardiovascular
Catheter Ablation - instrumentation
Catheters
Echocardiography
Female
Follow-Up Studies
Gender differences
Heart
Heart Diseases - prevention & control
Heart surgery
Humans
Male
Medical sciences
Middle Aged
Postoperative Complications - prevention & control
Punctures - instrumentation
Regression analysis
Retrospective Studies
Studies
Thrombosis - blood
Thrombosis - prevention & control
Treatment Outcome
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Summary:Guidelines largely based on closed-tip catheters recommend activated clotting times (ACTs) >300 to 350 seconds during atrial fibrillation (AF) ablation to prevent thrombus and char formation. Open irrigated tip catheters (OITC) may decrease complications and permit lower ACTs. This study evaluated factors contributing to vascular and hemorrhagic complications during AF ablation with emphasis on catheter type, anticoagulation level, procedural and clinical variables, and gender. In 1,122 AF ablations we examined catheter used, ACT level, gender, and complications. Target ACTs initially were >300 seconds and were decreased to 225 seconds for the OITC. Average ACT ranges were created: 350 seconds. Average ACT was 350 seconds (p = 0.038). Women were older (66 ± 10 vs 60 ± 10 years, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2010.10.048